YW 2023 Registration Form (2024)

Registration for camp requires different forms and permission slips in addition to this online form.

You MUST print and fill out the ones linked below and give them to your YW President BEFORE registration closes!

Click here for the Printable "LDS Parent or Guardian Permission and Medical Release Form"

If you need to get the form again, simply return to this page and select the links above. You do not need to register again.

Young Womans First Name*

Young Woman's Last Name*

Birth Date
Enter or select from the calendar below
(MM/DD/YYYY) format*+

What grade will you be in the 2023-2024 school year?*

Ward*

T-Shirt Size (Adult Sizes Only)*

Parent/Guardian Name*

Emergency Contact Number*

2nd Parent/Guardian emergency contact*

Second Emergency Contact Number*

Street Address*

City*

State*

Zip Code*

See Also

Photo Permission - Tech Forum

By entering my name and date below I give permission and consent for my child to participate in the rappeling, hiking, and other outdoor activities. I understand there are inherent risks involved with this activity and hold all leaders harmless in the event of an injury.

Name of Parent or Guardian
*

Date*+

By entering my name and date below, I give permission for my daughter to participate in The camp activities I have not specifically declined and authorize adult leaders supervising these activities 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 these activities and any transportation to and from all activities.

Name of Parent or Guardian
*

Date*+

Medical Information and Consent

Does your daughter have any of the conditions listed below?

If you do not wish to put this information here, you may click the link below and print this secion of the registration form. You must fill it out and give it to the Young Women's President of your daughters Ward. Without this information, the Young Woman will not be allowed to attend.

Click here for a printable Medical/Medication and Activity Release Form*

I am printing the form and filling out a hard copy

I am filling out the online form

Check All That Apply. check "None" if None.*

None

Special Diet

Allergies

Serious Allergic Reactions/Anaphylaxis

Chronic/recurring illness

Surgery/serious illness within the past year

Diabetes

Asthma

Physical conditions that limit activity

OtherOther

If you indicated that your child may have severe allergic reactions or susceptible to Anaphylactic shock. You must have your child bring an Epi-Pen or other medication needed to control the reaction. You cannot rely on there being another EPI-Pen available. Please indicate what allergen your child is severely allergic to and then include your nameas acknowledgement.

Allergen(s) Name of Parent or Guardian
*

If any of the above are selected, please explain below*

0/2000 characters

Non-Prescription Medication Information

By entering my name and date below, I give permission for my daughter to take Non-Prescription medicines administered by the nurse (such as: Benadryl, Sudafed, Tylenol, Ibuprofen, Pepto Bismol, etc.). If necessary, the camp nurse will provide/administer these medications.Medications must be given to a WARD CAMP LEADER, MEMBER of the STAKE YW PRESIDENCY, or CAMP NURSES prior to camp.
Name of Parent or Guardian
*

Date*+

Prescription Medication Information

Does your daughter need/may need to take Prescription Medications while at camp? If "YES", a "medications" section will appear below. You will need to complete the "Medications" section.

Need Prescription Medications?

MEDICATIONS

This form needs to be filled out only if you are sending medication with your daughter to camp.

Please note that any medication sent to camp will require the offical Church signed parent/guardian permission slip. This includes allergy medication and inhalers. Please read the instructions below carefully, sign, and return to your ward Young Women President prior to attending camp or on the day of departure. If written permission is given by parent/guardian, a camper will be allowed to keep her inhaler with her.

All prescription medication must be in the original bottle from the pharmacy with doctor’s instructions. All over the counter medication must also be in its original container, and stored in a large Zip-loc bag with the camper’s name and ward boldly labeled with indelible ink. Please give this medication to your Young Women President prior to attending camp or on the day of departure.

	Medication	Dose	How Often	For What Purpose
1	Medication	Dose	How Often	For What Purpose
2	Medication	Dose	How Often	For What Purpose
3	Medication	Dose	How Often	For What Purpose
4	Medication	Dose	How Often	For What Purpose
5	Medication	Dose	How Often	For What Purpose

Parent or Guardian Email Address*

YW 2023 Registration Form (2024)

References