Please complete the form below to register for the Winona Senior High Guatemala trip. All submissions will be reviewed by the Trip Leaders at Winona Senior High for final admission onto the trip.

Student Name

First Middle Last

Student Email Address

Student Phone Number

Student Date of Birth

Student Age At Time of Travel (March 2020)

Guardian Name

Guardian Phone Number

Guardian Email Address

Mailing Address

Emergency Contact Name

Emergency Contact Relationship To Student

Emergency Contact Phone Number (If different than guardian listed above)