2019 Summer Trip Pre-Registration
This form is for our 2019 Summer Trips : Okoboji Summer Camp, Pine Ridge Reservation Trips, and MOVE.
Participant's First Name *
Your answer
Participant's Last Name *
Your answer
Participant's Birthday *
MM
/
DD
/
YYYY
Participant's Phone number
Your answer
Participant's Gender *
Required
Participant's Grade (Entering 2019 School Year) *
Your answer
Parent/Guardian Name (First and Last) *
Your answer
Parent/Guardian Phone Number *
Your answer
Address *
Your answer
City, State, Zip *
Your answer
Preferred Email Address *
Your answer
Emergency Contact Name (First and Last) *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Relationship to Participant *
Your answer
What trip would you like to preregister for? *
Required
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