Lakewood Stake Youth Conference 2025

Lakewood Stake Youth Conference 2025 Registration - August 2, 2025

These forms are required to attend Youth Conference at Fort Steilacoom Park. Youth must be age 11 or older before January 1, 2025 to attend.
Participant Information
Member ID
Name*

Last Name
Ward*
Date of Birth*

MonthDayYear
Age on 1/1/2025*
Phone Number*

Area CodePhone Number
Phone*

CellHomeWork
Email*
example@example.com
Sex*

FM
T-Shirt Size*

Parents' Information

Parent/Guardian 1
Parent/Guardian 1*

First NameLast Name
Relationship to Child*
E-mail*
Primary Phone*
Alternate Phone
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 2
Parent/Guardian 2*

First NameLast Name
Relationship to Child*
E-mail*
example@example.com
Primary Phone*
Alternate Phone
Home Address Same as Parent/Guardian 1?

Yes
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contacts/Authorized Pickup

In the event of an emergency, please contact the following individuals in this order:
Emergency Contact #1
Full Name*

First NameLast Name
Primary Phone*
Alternate Phone
Relationship to Child*
Emergency Contact #2
Full Name*

First NameLast Name
Primary Phone*
Alternate Phone
Relationship to Child*

Permission, Agreement to Abide by Youth Conference Rules/Regulations and Photo Release
I give permission for my child or youth to participate in the event and activities listed above (unless noted) and authorize the adult leaders supervising this even to administer emergency treatment to the above named participant for any accident or illness and to act in my stead in approving necessary medical care. This authorization shall cover this event and trave to and from this event.

The participant is responsible for his or her own conduct and is aware of and agrees to abide by Church standards, camp or event safety rules, and other pertinent instructions. Participants' conduct and interactions should abide by Church standards and exemplify Christlike behavior.

Parents and participants should understand that participation in an activity is not a right but a priviledge that can be revoked if they behave inapproprately or if the pose a risk to themselves or others.
By signing below, I indicate I have read the activity rules and regulations and agree to abide by them. Furthermore, I understand that if I choose not to follow the rules and regulations I could lose privileges or be sent home.
Signature or youth*
Date Signed*

MonthDayYear
By signing below, I indicate that I have read the activity rules and regulations and agree to support the leaders in enforcing them. Furthermore, I understand that if my child chooses not to follow the rules and regulations she/he could lose privileges or be sent home.
Signature of Parent or Guardian Activity Approval*
Parent/Guardian Name*
Date Signed*

MonthDayYear
Please be advised that throughout the youth conference there will be video and photographs taken. These images may be used for presentations, future advertising or shared online. By signing below, I give permission for my child's image to be utilized in this manner.
Signature of Parent or Guardian (Media Release)*
Parent/Guardian Name*
Date Signed*

MonthDayYear
Should be Empty:

Lakewood Stake Youth Conference 2025 Registration - August 2, 2025

Participant Information

Parents' Information

Emergency Contacts/Authorized Pickup

Medical / Health Information

Medical Information

Physical Conditions That Limit Activity

Permission, Agreement to Abide by Youth Conference Rules/Regulations and Photo Release