Royal Rangers School Registration Form

Royal Rangers Essentials Registration
West Florida Royal Rangers Training Department
Additional documents for registration

Bring this registration form and the following documentation to the school office.

• State ID /DL
• Pastor letter of approval background screened
Student Information
Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Ethnicity
Email Address
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Group leader* Ranger Kids, Discovery, AR or ER, Outpost Coordinator
How long?
Have you previously attended this school?
If yes, what year?
Current Residence Information
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Primary Residence Information (if different from above)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Information
Name of Church

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact 1
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Emergency Contact 2
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Physician and Medical Information
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Insurance/Health Coverage (Company)
Please list any of the following: Current medications, Medication allergies, Food allergies, Chronic health concerns.

Notes
Please inform the office of any other vital information you think they may need to know in the event of an emergency. Thank you.
Should be Empty: