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Student Name *

First Name

Last Name

Student Name 2

First Name

Last Name

Student Name 3

First Name

Last Name

Student Name 4

First Name

Last Name

Transportation *

Please choose the option you are most comfortable with

I would like to get a ride with a youth leader.

I will arrange my own transportation to and from the event.

COVID Screening *

By checking the boxes below you confirm the following:

Do you confirm you are not experiencing any symptoms related to COVID-19 or have tested positive for COVID 19 within the last 14 days?

Do you confirm that you have not come into contact with someone with COVID 19 in the last 14 days and that you are not awaiting the results of a COVID test?