Facebook Instagram YouTube Flocknote

Holy Hiking Sign Up

Holy Hiking Registration - Brown's Woods
- This form is not accepting responses at this time.
  
  Parent/Guardian 1 Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian 2 Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Emergency Contact (if either parent/guardian cannot be reached)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Youth Attending REQUIRED Please fill out this field.
  
  Youth Info 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Please list any special needs for the day. Please enter valid data.
  
  Youth Info 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Please list any special needs for the day. Please enter valid data.
  
  Youth Info 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Please list any special needs for the day. Please enter valid data.
  
  Youth Info 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Please list any special needs for the day. Please enter valid data.
  
  Youth Info 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Please list any special needs for the day. Please enter valid data.
  
  I grant permission for my child to participate in this parish event described above that requires transportation to a location away from the parish site. If the signer below is not a minor but an adult participant, I also understand, agree to this waiver as outlined below. As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the participant relating to or arising during this trip. In consideration of the participant's participation in the Event, and on behalf of myself, the participant, my other minor children and our heirs, successors, and assigns, I hereby release, discharge and covenant not to sue St. Boniface, the Diocese of Des Moines and each of them, together with their employees, agents, chaperones, or representatives associated with this trip from any claim arising out of or related to the Event and in connection with any illness, accident or injury of the participant or cost of medical treatment in connection therewith. I further agree to indemnify and hold harmless the releases from any claim arising out of or related to this trip brought by any other parent or guardian of the participant (including reasonable attorney's fees and litigation expenses). Parent/Legal Guardians should print their name providing permission. Participants 18 or older should print their own name agreeing to the waiver above.
  I Agree to the above Please select this field.
  
  Print Name REQUIRED Please fill out this field. Please enter valid data.
  
  Submit
  
  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

St. Boniface Catholic Church

Waukee, IA

Holy Hiking Sign Up

Holy Hiking Registration - Brown's Woods