KREWE Winter Summit - Adult Leaders

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Welcome to the registration and liability form for KREWE Winter Summit at Camp Tekakwitha from February 21-23-2020. PLEASE ARRIVE TO CAMP BY 5PM ON FRIDAY, FEB. 21.

This form is ONLY for adult leaders, priests, and young adults.

No paper form will be needed as this acts as your liability form and registration. Once you submit this form, your spot is officially reserved.

First Name *

Last Name *

Male or Female? *

Male

Female

I am registering as... *

Youth Minister/RE Coordinator

Campus Minister

Priest

Other Adult Chaperone (21 and older)

Young Adult (Out of high school, but under 21, not an official chaperone)

Required

Which parish or group are you representing? *

Home Address of Adult *

Street Address, City, Zip Code

Cell Phone Number of Adult *

Email Address of the Adult *

Adult Date of Birth *

In case of emergency, please contact: *

Relationship of Emergency Contact to You *

Main Phone Number of Emergency Contact *

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