Love Begins Here Lead Missionary Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Welcome to the Love Begins Here Lead Missionary (Chaperone) Registration! We are so excited to have you join us on this wonderful opportunity.

This form is for adult Lead Missionaries who will be chaperoning on a middle school or high school Love Begins Here mission trip.

Once you submit this form, your spot is officially reserved. There is no cost for chaperones to attend, but chaperones must be accompanying a group from a parish and have completed VIRTUS training through the Diocese of Green Bay. All lead missionaries MUST BE trained in VIRTUS by June 1, 2021!

First Name of Adult Chaperone *

Last Name of Adult Chaperone *

Parish Group *

This is the parish you are accompanying as a chaperone.

Week(s) you desire to chaperone: *

MS 1 - St. Peter the Fisherman Parish, Two Rivers (June 13-16, 2021)

MS 2 - Our Lady of Lourdes Parish, DePere (June 20-23, 2021)

MS 3 - St. Paul Parish, Combined Locks (July 5-8)

HS 1 - St. Bernard Parish, Appleton (June 27-July 1, 2021)

HS 2 - St. John the Baptist Parish, Howard (July 11-15)

Required

I am registering as... *

Parent

Youth Minister/RE Coordinator

Priest

Adult Chaperone (21 and older)

Young Adult (Out of high school, but under 21)

Campus Minister

Religious Sister

Other:

Required

Have you chaperoned on Love Begins Here before? *

This is my first time!

I chaperoned last year!

Other:

Required

Each chaperone will be asked to drive their car with a small student group to the work sites. How many students would you be able to take in your car? *

Example: If your car has 5 seats total, you have room for 4 students (one spot being taken up by you, the driver). Please keep in mind space needed for social distancing.

5 (van or suburban)

6 (van or suburban)

Home Address of Adult Chaperone *

Street Address, City, Zip Code

Home City and Zip Code of Adult Chaperone *

City, Zip Code

Cell Phone Number of Adult Chaperone *

Email of the Adult Chaperone *

Adult Chaperone Date of Birth *

YYYY

Will you be 21 years old or older during your time at LBH? *

Yes

Size of shirt *

In case of emergency, please contact: *

First and Last Name

Relationship of Emergency Contact to You *

First and Last Name

Spouse

Parent

Sibling

Friend

Other:

Required

Home Phone Number of Emergency Contact *

Cell Phone Number of Emergency Contact *

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms