Registration | HermistonStake Youth

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Pioneer Trek Registration

First Name:

Last Name:

Phone:

Birthdate:

Emergency Contact:

Emergency Contact Phone:

Are you a Youth or Adult?

Youth

Adult

Gender:

Male

Female

Ward or Branch:

Boardman

Butte

Desert View

Meadows

Sandstone

Umatilla River

Willow Creek

Columbia River

Fossil

Guest

All meals will be provided during trek. Our youth will be well fed! A dairy and gluten free option will be available for every meal. If you need additional accommodations for meals due to medical reasons, a Medical Statement Form must be filled out and turned into your ward leaders before April 1st. The form can be accessed here: MEDICAL STATEMENT FORM

Do you have any allergies? If yes, please explain.....

Will you be bringing a friend or family member who is not a member of our Stake? If yes, please include their name, age, and gender below.....

Please include any additional information you think we should know prior to trek....

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