Activate Getaway 2024

ACTIVATE GETAWAY

JUNE 12, 2024 @ 3-5PM
Student Name*

First NameLast Name
Student Cell Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender*
CURRENT Grade*
(2023-2024 School Year)
Friend Request (please list 1-3 names)

PARENT/GUARDIAN INFORMATION
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email Address*
yac@yacherd.com
Parent/Guardian Phone Number*

Area CodePhone Number

MEDICAL INFORMATION
Has your student already completed a registration for another 2024 YAC trip?*

Yes, my student registered for the Confirmation Retreat 2024!Yes, my student registered for Discovery Weekend 2024!Yes, my student is registered for another YAC Summer 2024 Trip (Sr. High Lake Trip, Six Flags Getaway, Jr. High BigStuf Trip, Sr. High Rafting Getaway, Mission Week, Braves Game Getaway)!No, my student has not currently registered for other 2024 YAC trips
Has your student's medical information or health insurance information changed since you registered for one of the above trips?*

No, all of their medical & health insurance information is the same!Yes, my student's medical and/or health insurance information has changed
Yay! Since you've already filled out a medical form and your student's medical information has not changed, you don't need to fill out another one for the Activate Getaway! With our new medical information system, you are not required to fill out another Medical Information Form until 2025. We can't wait to hang out with your student at Activate!

Click the "Submit" button below to go to the Activate Getaway Payment Page!
Since your student's health information has changed, we'll need a new medical form.

Please click the "Submit" button below to go to the Medical Information Form. Make sure to have your health care provider information handy.
Our Medical Information Forms are now collected annually. After filling out the medical information once in 2024, you will not have to fill it out again until 2025!

Please click the "Submit" button below to go to the Medical Information Form. Make sure to have your health care provider information handy.
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ACTIVATE GETAWAY

PARENT/GUARDIAN INFORMATION

MEDICAL INFORMATION