2022 Trek Registration

Register now for the 2022 Cartersville Stake Trek!

When: June 8, 2022 - June 11, 2022
Where: Fort Mountain State Park, Chatsworth, GA
Who: All Youth ages 14-18 (or turning 14 in 2022). Graduating Seniors are encouraged to participate.
Cost: Free
Registration Closes: May, 1, 2022

Additional Information:

To stay up to date on the latest Trek information check out https://www.cartersvilleyouth.org/trek/

2022 Youth Theme & Trek Fireside

All youth, parents and youth leaders are encouraged to attend a fireside on Saturday, January 15th at 6:30 p.m.
Location: Cartersville Building - 870 Peeples Valley Rd NE, Cartersville, GA 30121

REGISTRATION FORM

PARTICIPANT INFORMATION

Registration Type *
Gender *
Primary Phone Type *
Secondary Phone Type
Address *
Address
City
State/Province
Zip/Postal

Parent/Guardian Information

Primary Phone Type *
Secondary Phone Type

Emergency Contact

(For youth, someone other than a Parent or Guardian)
Primary Phone Type *
Secondary Phone Type

MEDICAL INFORMATION

Does the participant Require a Special Diet? *
Does the participant have any allergies? *
Is the participant taking any prescription medication or over-the-counter (OTC) drugs? *
Can the participant self-administer his or her medication? *

PHYSICAL CONDITIONS THAT LIMIT ACTIVITY

Does the participant have a chronic or recurring illness? *
Has the participant had surgery or a serious illness in the past year? *

OTHER ACCOMMODATIONS OR SPECIAL NEEDS

PERMISSION, MEDICAL AND RECORDING RELEASE

Permission & Medical Release *
I give permission for my child/youth to participate in the event and activities listed above (unless noted) 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.
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. Participants’ conduct and interactions should abide by Church standards and exemplify Christlike behavior.
Parents and participants should understand that participation in an activity 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.
Covid-19 Acknowledgement *
Under Georgia law, there is no liability for an injury or death of an individual attending this event if such injury or death results from the inherent risks of contracting COVID-19. You are assuming this risk by attending this event.
Participant Release (Release to Use Name, Image, Voice, Likeness, and Performance) *
I irreversibly grant to Intellectual Reserve, Inc., its related entities, and their respective employees, agents, and representatives (collectively called “IRI”), the full right to create and obtain, in the past, present, and in the future, images, photographs, video, audio, interviews, stories, personal histories, performances (vocal, instrumental, dramatic, or otherwise), mixes, and any other recordings, documents, or materials, in any now known or future media, of my or my minor child's name, image, voice, likeness, performance, and other items (collectively called “Recordings”). I also authorize IRI to copyright, adapt, edit, translate, summarize, reproduce, perform, display, distribute, publish, license, sublicense, sell, broadcast, post or stream over the Internet, and otherwise use and allow others to use any and all parts of the Recordings, forever and throughout the world, in any and all manners, and in any and all forms of media that IRI believes suitable.
I agree that I shall have no right, title, or interest in or to the Recordings (or to any work comprising or based on the Recordings, in whole or in part), and that all right, title, and interest in and to the Recordings belongs to IRI. I waive any and all right to payment or other compensation arising from or related to the Recordings. I will not state or imply, or allow others to state or imply, that IRI approves of or endorses me or my activities. I further agree to release, defend, and hold IRI harmless from any claims, damages, or liabilities related to the Recordings or IRI’s use thereof. I understand this Release is governed by the laws of the State of Utah, U.S.A.

Electronic Signature Consent: The parties agree that this registration, permission, and medical release may be electronically signed. The parties agree that the electronic signatures appearing herein are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.

 

 

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Countdown to Trek 2022: 184 Days 23 Hours 41 Minutes 16 Seconds
Register Now!