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United Youth Mission Trip Sign Up - High School & Middle School: East Bank, WV
During the week of June 30-July 6th, 2024 we are heading to East Bank, West Virginia for a mission trip to serve with Group Mission
s.
This form is for both adult leaders and youth participants.
Cost: $600, Due by May 30th.
Registration Closes on March 1st.
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Participant's Age by 6/30/2024
Your answer
Participant's Name
Your answer
Participant's Birthday
MM
/
DD
/
YYYY
Best Contact number for Participant
Your answer
Best Contact Email for Parent or Guardian
Your answer
What Church are you from?
Option 1
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Church Leader's Number and Contact Number
Your answer
Participant Shirt Size
XS
S
M
L
XL
XXL
XXXL
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Emergency Contact Name
Your answer
Emergency Contact Number
Your answer
Any other contact information to update?
Your answer
Has this Youth been on a Mission Trip Before?
Yes
No
Clear selection
Are there any dietary or medical concerns trip leaders should be made aware?
Your answer
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