The Stand Camp 2019 Registration Form
Complete the following form. See Payment options below
Email address *
Name and Surname *
Your answer
Address *
Your answer
Age *
Your answer
Gender *
Cell Number *
Your answer
High School
Your answer
Grade
Youth Group // Church *
Your answer
Dietary // Medical Needs
Your answer
Emergency Contact Name *
Your answer
Emergency Phone Number *
Your answer
Consent for Medical Treatment & Indemnity *
By checking this box, the parent and guardian, in a case of an emergency, hereby agrees to the performance of such treatment on the above mentioned minor, including anesthesia and surgery, as the attending doctor or physician may deem necessary. The parent and guardian also hereby agrees that they not hold The Stand, its leaders or volunteer assistance responsible for any illness, injury, damage or loss incurred by the above mentioned minor during the course of their involvement with The Stand Camp 2019.
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.