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 to be added to the CHWC 2022 list. We have secured more spots at camp and a second bus! Once complete, wait for an e-mail with your next set of instructions.
- 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 Guardian/Parent 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.
- Parish you attend/Religious Affiliation if non- Catholic REQUIRED Please fill out this field. Please enter valid data.
- Current Grade Level REQUIRED 7th grade 8th grade 9th grade 10th grade 11th grade 12th grade Young Adult (out of high school and age 18-20) Adult (21+) Please fill out this field.
- $150 Deposit Payment REQUIRED Please fill out this field.
Submit

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Step 2: Deposit

**Be sure to hit the above RED SUBMIT buttom above BEFORE moving on to payment.**

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: