CHWC Mission Trip! July 14-20, 2024 - Marshalltown, Iowa
Complete the information below to register for this summer's mission trip open to teens entering 8th grade in the fall and older. Once you complete the form, you will receive a message and you will need to click the link that will appear on the screen to be redirected to make your $100 deposit to secure your spot on the trip. Your registration is complete once all information and deposit have been received. An email will be sent to parents confirming your teen has a spot on the trip.

*Please submit 1 form per child.

Questions? Email Marta Robak at mrobak@saintzachary.org
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Teen's Name *
Teen's Last Name *
Mother's First and Last Name *
Mother's Phone Number *
Mother's Email Address *
Father's First and Last Name *
Father's Phone Number *
Father's Email Address *
Teen's Date of Birth  *
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Home Address (street & city) *
Teen's T-Shirt Size  *
Dietary restrictions or Allergies *
I understand that in order for my child to have a spot on this trip, payment and registration information must be received.  *
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