MidWinter 2014 - Portland, Oregon - Reedwood Friends Church
Please complete this registration, download the medical release form, and send a check to NWYM with the medical release.  If more than one high school student from a household is registering, please complete multiple registration forms.
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Name of Student *
First and Last
Intended Year of High School Graduation *
Graduating Class of.....
Address of Student *
Name of Church
You do not need to already attend a church, but if you are part of a church group or coming with one we'd like to know which one.
Email Address of Student *
Email Address of Parent *
Phone # for Parent *
Contact Phone # for Student
If the student has an additional phone # please list it.
Name 1-3 people you would like to be in the same group with.
We'll do our best.
Bring a rain jacket!!! *
Choose one
The student and parents understands that no cell phones or other media devices should be brought to MidWinter (ipods, computers, phones, etc.) *
Students can make arrangements for these devices to be locked in a vehicle or turned in at registration.  If a call is needed to be made that can be arranged with the program staff.
Special Diets?
Are there any food allergies or special diet needs?  Please explain.
I understand the student is to bring a signed medical release and payment in full at time of arrival to MidWinter. *
Some churches may have scholarships available, contact your local church for information.  The cost is $65.
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This form was created inside of Northwest Yearly Meeting.