Trek 2024 Registration

Pioneer Trek Registration 2024

Spokane East Stake
Participant Information
Participant Name*
Participant Type*
Date of Birth*

MonthDayYear
Ward*
Name of Friend (for visitors)
Participant Cell Phone*
type N/A if not applicable
Participant Email*
type N/A if not applicable
Yes (I am OK with my/my child's picture being shared either by email or on a private social media page)No (Please do not post pictures of me or my child)
I understand that unless otherwise arranged with the Bishop, I am responsible to pay the participant fee, estimated $100 or less. Checks are paid to the ward using a tithing slip and filling out the "Other" field. Payments cannot be submitted online.

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. List the name of a person who can be contacted in the event of an emergency or illness if parent/guardian cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age.
Emergency Contact
Full Name*

First NameLast Name
Primary Phone Number*
Format: (000) 000-0000.
Secondary Phone Number
Format: (000) 000-0000.
Relationship*

Emergency Contact