I am registering my: *

Young Woman

Young Man

I am registering for (check all that apply): *

Note: Registration for Young Women Camp is closed. Contact ruth.margetts@yahoo.com for more information)

Young Men Camp (July 7-10 for all young men)

Youth Conference (July 23-24 for youth turning 14 or older in 2021)

Youth Name *

First Name

Last Name

Youth Birthday *

MM

DD

YYYY

Youth Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Youth Cell Phone

(###)

###

####

Parent or Guardian Name *

First Name

Last Name

Parent or Guardian Cell Phone *

(###)

###

####

Ward/Branch *

Keene

Lowell 1st or 2nd

Merrimack or Nashua 2nd

Nashua 1st

Peterborough

T-Shirt Size (adult sizes) *

Small

Medium

Large

X-Large

XX-Large

XXX-Large

Activity Opt-out

Please indicate below any activities that you DO NOT want your youth to participate in.

Archery

Boating

Crafts

Rifle Shooting

Swimming

Parent/Guardian Acknowledgement *

For all parents: I have read, understand, and agree to this release and permission form.

Acknowledged and agreed