Holy Sweat Spring Break

PARTICIPANT INFORMATION

Name

Phone

Church home

PARENT | EMERGENCY CONTACT INFORMATION

Parent/Guardian Name

Parent/Guardian Email

This address will receive a confirmation email

Emergency Contact Name

Emergency Contact Phone

PHOTO/VIDEO RELEASE:

Please be aware that this event may be photographed. Your submission of this form and participation in the event grants Park Chapel permission to use your picture, silhouette or reproductions of your physical likeness and voice in any manner associated with promotion and/or celebration of church events.

COST

Total cost is $500. Deposit is $75.

Deposit/Payment

Checking the box below indicates that I understand that the church is a recognized charitable organization and you will receive a receipt of your gift for tax purposes. Per IRS regulations, Park Chapel has complete discretion and control of all contributions intended exclusively for the pursuit of its exempt purposes and is committed to providing reasonable measures to ensure that donor-preference gifts are used for their intended exempt purposes. To that end, all gifts are non-refundable. *

I understand all funds are non-refundable

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

March 15-20, 2025

DEADLINE to Register: Sunday March 2, 2025

Please fill out this form and click submit.
WHO: High School Students Only
WHAT: A Mission Trip serving with those in need in Chicago IL.
WHERE: Chicago
WHEN: March 15th-20th
COST: $500

If you have any questions please email Kiefer Honeycutt at khoneycutt@parkchapel.org
The deposit is $75

Holy Sweat Spring Break

Description

Please Fix the Following