Survey

Multi-Stake Youth Conference

June 21-22, 2013 in Hillsboro, OR

Registration Form

* Indicates required field

Name *

First

Last

If Male *

Stake - Ward *

If Female *

Parent/Guardian Name *

Parent Phone Number *

Parent Cell Number *

Siblings Attending *

Roommate Preference

Name *

First

Last

Stake - Ward *

Comments or Special Needs

Allergies *

Cats Dogs

Other Allergies *

If special diet, please explain *

Other Comments/Needs *

Submit

Please remember that you will also be required to complete a parental permission for for this activity. Please see your class/quorum adviser to acquire this form.