TRIP REGISTRATION
All information marked with an * must be completed to register!

This form is for members of the Waynesboro Youth Group participating in events
away from home. If you are a guest looking to register for an event occuring
at the Waynesboro Church, you will need to fill out the Event Registration Form.

Personal Information
*Name:
*Address:
*City:
*State:
*Zip:
*Sex:
*Age:
*Grade:
*Which trip are you registering for?

Contact Information
*Home Phone:
- -
Cell Phone:
- -
Email:
Other:
(optional)

Emergency Information
*Contact Person:
*Relationship
*Home Phone:
- -
Cell Phone:
 - -
*Known Allergies:
*Medication:

T-Shirt Request
(if applicable)
Size:
Quantity:

If you have a friend or relative you prefer to be housed with,
please enter their name below:

(NOTE: Requests for members of the opposite sex will be ignored)

   

If you have any other issues, questions, or comments conerning this trip,
please e-mail Alfred at:
tooletime40@hotmail.com