Catholic Heart Workcamp New Castle, PA        2022 Registration Form /Contract - Basic Info
June 11 - 18, 2022 ** Please note, registration is not confirmed until the $100 (OR $75 each for 2 or more participating from the same household) downpayment is received.**
Sign in to Google to save your progress. Learn more
Email *
I am registering as a *
First Name *
Last Name *
Grade in September 2022 *
Parish Name *
Parent Name - First and Last (Chaperones Skip)
Parent/Chaperone Email Address *
Parent/Chaperone Phone Number *
Emergency Contact Name *
Emergency Contact Number *
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.
Will your student require medication administration during the trip? (This includes ALL medications, both OTC and Presription Medications)  A member of our leadership team will follow up with you before the trip. *
Shirt Size - All Adult sizes *
I acknowledge that my registration is not confirmed until my $100 (OR $75 each for 2 or more participating from the same household) downpayment has been submitted.  Payments can be mailed to or dropped off at St. Gabriel Parish - 900 Geiger Street, Neenah, WI 54956 ATTN:  Meredith Lauer *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy