OGDEN WEST TREK REGISTRATION FORM
Complete the form below to register for our Stake Youth Trek on June 10-13, 2026 at Deseret Land and Livestock Ranch.
Participant Information
Submit Photo
*
Full Name
*
First Name
Last Name
Who are you?
*
Please Select
Youth Trekker
Ma or Pa
Adult Stake Trek Committee Member
Stake Leader
Gender
*
Female
Male
Ward
*
Please Select
Kanesville
Taylor 1st
Taylor 2nd
Taylor 3rd
Taylor 4th
Taylor 5th
Taylor 6th
Your Cell Number
*
-
Area Code
Phone Number
Your Email
*
example@example.com
Your age as of today
*
How excited are you to go on trek?
*
1
2
3
4
5
Not very...Very
Talents (check all that apply)
Sing (solo)
Sing (group)
Guitar
Violin
Harmonica
Acting
Other
Emergency Contact Information
Name of Emergency Contact
*
Emergency contact primary number
*
-
Area Code
Phone Number
Emergency contact secondary number (if desired)
-
Area Code
Phone Number
Email of Parent or Guardian
*
example@example.com
Medical Information
If you are a youth, this section needs to be filled out with a parent.
Does the participant require a special diet?
*
Yes
No
If yes, please explain the dietary restrictions.
Does the participant have any allergies?
*
Yes
No
If yes, please list the allergies.
Is the participant taking any medication or over-the-counter drugs?
*
Yes
No
If yes, can the participant self-administer his or her medication?
I would like to visit with an adult trek leader about medical or health concerns of my child.
*
Yes
No
Physical Conditions
If you are a youth, this section needs to be filled out with a parent.
Rate the physical shape that the participant is in.
*
Rows
1 (poor)
2
3
4
5 (great)
Physical Shape
Does the participant have a chronic or recurring illness?
*
Yes
No
If yes, please explain.
Has the participant had surgery or a serious injury in the past year?
*
Yes
No
If yes, please explain.
Identify any other limits, restrictions, or disabilities that could prevent the participant from fully participating in the event or activity
Identify any other needs or considerations the participant has that event leaders should be aware of.
Permission
If you are a youth, this section needs to be filled out with a parent.
I understand and agree that pictures and video taken on trek may be shared on the trek website, trek video, trek slideshow, and trek social media accounts.
*
I understand and agree
I give permission for my child or youth to participate in the event and activities listed above and authorize the adult leaders supervising this event 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 travel to and from this event.
*
I give permission.
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. Participant's conduct and interactions should abide by Church standards and exemplify Christlike behavior. Parents and participants should understand that participation in and event is not a right but a privilege that can be revoked if they behave inappropriately or if they pose a risk to themselves or others.
*
We understand and agree
Participant's Signature
*
Parent or Guardian's Signature (if a youth)
Continue
Continue
Should be Empty: