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Catholic Mission Trips Kentucky 2023 Registration/Contract - Basic Info
July 23-30, 2023 - Total trip cost is $1,000 ** Please note, registration is not confirmed until the $200 down-payment is received.**
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Email
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Your email
I am registering as a
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Student (one registration per student)
Chaperone (one registration per chaperone)
First Name
*
Your answer
Last Name
*
Your answer
Grade in September 2023
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9th Grade
10th Grade
11th Grade
12th Grade
Just graduated 12th grade
Chaperone
Parish Name
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St. Mary Menasha
St. John Menasha
St. Patrick Menasha
St. Margaret Mary Neenah
St. Gabriel Neenah
Other - Chaperone from family or home parish is required
Parent Name - First and Last (Chaperones Skip)
Your answer
Parent/Chaperone Email Address
*
Your answer
Parent/Chaperone Phone Number
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Your answer
Emergency Contact Name
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Your answer
Emergency Contact Number
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Your answer
Please list any allergies or medical conditions we need to know about. A member of our leadership team will follow up with you before the trip. Please skip if there are none.
Your answer
Will your student require medication administration during the trip? (This includes ALL medications, both OTC and Prescription Medications) A member of our leadership team will follow up with you before the trip.
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Yes
No
Shirt Size - All Adult sizes
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XS
S
M
L
XL
XXL
I acknowledge that my registration is not confirmed until my $200 down-payment has been submitted. Payments can be mailed to or dropped off at St. Margaret Mary Parish
St. Margaret Mary
Attn: Juanita Harder
439 Washington Ave
Neenah, WI 54956
*
Yes
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