Online Application Candidate & Parent: Please complete the online QUEST Application below. "*" indicates required fields Candidate InformationQuest Weekend:*Select WeekendFebruary 2-3, 2024 - Quest #99April 5-6, 2024 - Quest #100October 4-5, 2024 - Quest #101December 13-14, 2024 - Quest #102Select the month for the weekend you are attendingName* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone*Email* Birthdate* Month Day Year Age* 13 14 15 Adult (Additional Info Including Background Check Needed) Male or Female* Female Male Shirt Size Name of School* How Many Brothers Do You Have?* How Many Sisters Do You Have?* Have Any Of Them Made QUEST?* Have Any Of Them Made TEC?* Are You Involved At Church?* If Yes, How? What Church Do You Attend? What Are Your Interests?* How Did You Hear About QUEST? Why Do You Want To Make A QUEST?* Parents SectionParents, please complete the following. When complete, please sign & submit the appplication.My child's level of maturity is:* Immature Average Mature When relating to peers, my child is:* A Loner Quiet Disliked Average Well-Liked Respected Talkative A Follower Domineering My child's attitude towards religion is:* Indifferent Confused Positive Enthusiastic Unsure Participation in discussion would be:* Quiet Average Talkative Domineering Fair Leader Additional Comments Are Welcome:I give permission for my child:Child's Name* to be treated by a doctor in case of an emergency during the QUEST retreat. I further release Great River TEC from liability for any physical injury that my child might incur in conjunction with the QUEST retreat.Parent Name* Electronic Signature* Please type your First and Last NameAgreement* I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above terms. Medication* Allergies* Parent Contact InformationParent #1 Name* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Parent #2 Name* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Payment InformationThe cost of the Quest & Re-Quest is $50.00. Full payment is due with application to hold your place.Payment* $50 Registration Fee - Pay Online I have made prior arrangements Please describe alternative payment arrangementsIf you have made prior payment arrangements (such as financial assistance or parish assistance, please provide details here)Total Amount Due Now PhoneThis field is for validation purposes and should be left unchanged.
