registration

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registration

Email *

Name of Pathfinder: First ,Last *

Address: Street- City- State- Zip code
*

Date of Birth
*

YYYY

Gender
*

Male

Female

Is this your first year in Pathfinders?
*

Yes

Are you a returning OCU Christian Crusaders?
*

Yes

What church do your attend?
*

Pathfinder Email address if applicable
*

Pathfinder Phone number if applicable
*

Parent 1 Name
*

Parent 1 phone
*

Parent 1 Email address
*

Parent 2 Name
*

Parent 2 phone
*

Parent 2 Email address
*

What is the Name of your Family Doctor and Phone#
*

Insurance Company Name and group number:
*

I plan to pay Early Registration fee of $30 due by Oct 2.
*

Yes

I plan to pay late Registration fee of $40 after Oct 2 nd
*

Yes

List all Food Allergies:
*

I hereby agree as a Pathfinder to conduct myself in a mature manner, adhering to both the
Pathfinder Pledge and Law. List the name of the Pathfinder if they agree:
*

In case of an emergency, I hereby give permission to the physician selected by the local and or
hosting Pathfinder club directors to hospitalize, secure proper treatment for, and to order
injection, anesthesia, or surgery for my child. I also hereby voluntarily waive any claim against
the South-Central Conference of SDA, the Oakwood University SDA Church and the local or
hosting Pathfinder club for any accidents that may arise in connection with the activities of the
Pathfinder club.
*

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