Challenge Conference Trip 2026Registration (Kansas City)

Participant Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Grade for 2026/2027 school year*

8th9th10th11th12thgraduated 2026adult chaperone/leader
Please provide an email to receive the link to the required Challenge Waiver to be completed and signed by a parent.*
example@example.com
Please list any allergies:

To grant permission, this form must be completed, signed, and dated by parent or guardian.
TRAVEL PERMISSION:

If transportation is provided, I give permission for my child to be transported by ECC Student Ministries.
Travel Permission:*

Yes- I give permission for my child to be transported by ECC Student MinistriesNo- I do not give permission for my child to be transported by ECC Student Ministries
Parent/Guardian Name:*

First NameLast Name
Cell/Phone Number*
Please enter a valid phone number.
Date*

MonthDayYear
Date
Signature*

Clear

Registration Deposit Payment:

You may pay by cash or check (made out to ECC Students), or online by credit/debit card.
I will be paying by:*

Cash/Check/ECC Cash/OtherCredit/Debit (Online)
Cash/Check/ Other Payments

If you are paying by cash/check/other, you may turn in your payment at the church office or leave your payment in the lockbox at the ECC Students Kiosk lockbox. If using the lockbox, please use the payment envelopes and include your name and the event you are paying for on the outside of the envelope.

Online payment (credit/debit)*

Challenge Conference Registration Deposit

$100.00

Total

$0.00

Challenge Conference Trip '26