The WICHITA MISSION TRIP
June 12-14, 2024
Student Info:
First Name
Last Name
Gender
Male
Female
I'd rather not say
Parent/Guardian Info:
First Name
Last Name
Email
Phone Number
Are you looking to be a student leader on this trip?
Yes
No
Grade (current as of 23-24 school year)
8
9
10
11
12
Shirt Size (adult sizes only)
Small
Medium
Large
XL
XXL
XXXL
Medical Info:
Prescription Medication?
No
Yes
List all prescription medications
Any Food Allergies?
No
Yes
List all food allergies
Permissions
:
I give permission for Hope Community staff to administer non-prescription medication (such as Tylenol, Tums, etc) to my child for non-emergency situations
No
Yes
Signature
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