CHWC Registration

- Youth Ministry/Young Adult

Step 1: Registration Form
The maximum number of form submissions has been reached. This form is currently not available.
- Please complete the form and submit deposit to be added to the CHWC 2025 list.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Guardian/Parent Name (s) REQUIRED Please fill out this field. Please enter valid data.
- Primary Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
- Secondary Guardian/Parent email Please enter an email address.
- Primary Parent/Guardian Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Student Email Please enter an email address.
- Student Cell Number Maximum 20 characters Please enter a phone number.
- Did someone refer you for the first time this year? Please enter valid data.
- Parish you attend/Religious Affiliation if non- Catholic REQUIRED Please fill out this field. Please enter valid data.
- Current Grade Level REQUIRED 8th grade 9th grade 10th grade 11th grade 12th grade 12th grade but will be 18 on the trip Young Adult (out of high school and age 18-20) Please fill out this field.
- $150 Non-Refundable Deposit Payment REQUIRED Please fill out this field.
Submit Step 1 (Waiting List)

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Step 2: Deposit

**Be sure to hit the above RED SUBMIT button above BEFORE moving on to payment.** You should see a big "HOORAY" above:)

If paying via scrip, you can email the scrip office to find out how much you have in your account/request funds for CHWC down payment.
CHWC Down Payment -$150

CHWC Student's Name: