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* 1. What is the participant's full name?

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* 2. What is the participant's school grade (must be 6th-12th grader)

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* 3. To limit COVID exposure, participants must be from our local area. What is the participant's school name?

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* 4. To limit COVID exposure, participants must reside in the greater Orlando area. What is the home address of the participant?

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* 5. What is the participant's cell phone number?

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* 6. What is the name of the parent/guardian who is the primary emergency contact?

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* 7. What is that parent/guardian's cell phone number?

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* 8. What is the name of the person who will be picking up/dropping off the participant each day/night?

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* 9. What is the name of the participant's health insurance company?

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* 10. What is the Group # and Policy # of the participant's health insurance?

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* 11. Does the participant have any allergies or other medical conditions that could be triggered by food or other factors during the event? Please list/explain all.

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* 12. Will the student be carrying any prescription medication with her/him during the event times? If so, please list/explain here.

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* 13. Is there anything else we need to be aware of that your student might need extra care with during the event? If so, please explain. 

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* 14. Will your student need to be absent at any time during the event? If so, please put a check by the time period in which the participant will be absent. Pastor Eric will call you to confirm the reason and amount of time to be away. If your student will attend the entire event, put a check beside option one.

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* 15. If your student will be absent, please explain the reason.

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* 16. What is your student's t-shirt size?

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* 17. Will you provide a mask for your student to wear, or do we need to provide one?

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* 18. The event cost is $50/participant. This covers 4 meals, snacks, band, speaker, small-group leaders, t-shirt, and a book. Will you be paying online or with check/cash?

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* 19. How can Pastor Eric pray for the participant and your family at this time? 

0 of 19 answered
 

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