2020 ECHO Teen Electronic Application Form June 22th - 26th
This is the electronic application form for Teens applying to attend the Echo Chicago 2020. The Teen applicant will also need to turn in the Parent Consent Form and all the payments required (which can be found and downloaded from www.RespectLifeChicago.org). This form is one of the first steps to officially register for Echo Chicago 2020. If your Parental Consent Form and Payments are not received at the appropriate deadlines, your application form will be removed. Please contact rpingoy@archchicago.org or call 312-534-5355 for more information. Credit Card payment option will be available soon.
Echo Chicago 2020
First Name *
Your answer
Last Name *
Your answer
Male or Female *
Email *
Your answer
Address *
Your answer
Phone number (xxx-xxx-xxxx) *
Your answer
Shirt size *
Grade as of Fall 2020 *
High School *
Your answer
Diocese *
Your answer
Parish *
Your answer
PERSONAL INFORMATION
Have you attended Echo in the past? *
How familiar are you with St. John Paul II's Theology of the Body *
none
very knowledgable
ECHO is an immersive experience into the depths of our identity as men and women through the lens of St. John Paul II's Theology of the Body. We explore themes of sexuality, vocation, prayer, and relationships. We want to make sure you want to dive in! Please tell us in 100-200 words why you want to attend Echo. *
Your answer
I will be 18 years or older at the time of Echo Chicago. Therefore, I understand that I must submit proof of Safe Environment Certification and a completed background check by my home parish by Friday, May 31st, 2019. *
While we cannot guarantee who your roommate will be during camp. All requests will be taken in to consideration when assigning housing. I would like to request the following person as my roommate:
Your answer
MEDICAL INFORMATION
Please take care in filling out this portion. It provides crucial information for caregivers in the event of illness or medical emergency.
Main Emergency Contact Name (First & Last) *
Your answer
Emergency Contact Relationship to participant *
Your answer
Emergency Contact Phone Number (xxx-xxx-xxxx) *
Your answer
Family Doctor *
Your answer
Doctor's Phone Number (xxx-xxx-xxxx) *
Your answer
Family Heath Care Carrier *
Your answer
I/My child will carry a valid insurance card during Echo Chicago *
Allergic Reactions (medications, plants, insects, etc.) *
Your answer
Food Allergies & Dietary Restrictions *
Your answer
Any physical limitations?
Your answer
Have you recently been exposed to contagious diseases or conditions, such as mumps, measles, chickenpox, etc
Primary Parent/Guardian (first name, last name) *
Your answer
Primary Parent/Guardian's Email Address *
Your answer
Primary Parent/Guardian's Phone Number (xxx-xxx-xxxx) *
Your answer
Name of Second Parent/Guardian (first and last name) *
Your answer
TRAVEL INFORMATION
Please note that we are not able to provide overnight accommodations before or after the camp - only during camp.
Mode of Transportation *
SHUTTLE RESERVATIONS
We offer round trip and one-way options. Unfortunately, we can only accommodate those flying to Midway International Airport (MDW) and NOT O'Hare International Airport (ORD). Depending on your need, the appropriate fee will be added to your registration balance. At this time, we are only able to offer the shuttle at the days and times listed below. We apologize for any inconvenience this may cause.
One-Way Shuttle to or from Midway International Airport (MDW): $15.00. Round-Trip Shuttle to AND from Midway International Airport (MDW): $25.00. *
Please save me (my teen) a spot to be picked up on Monday, June 22, 2020. *
Please save me (my teen) a spot to be dropped off at the airport on Thursday, June 25, 2020. *
Please make your flight arrive and depart from MDW (Midway International Airport). ARRIVING FLIGHT: Please arrive into MDW (Midway International Airport) before 1pm on Monday, June 22, 2020. DEPARTING FLIGHTS: Please depart from MDW (Midway International Airport) NO EARLIER than 6:00pm on Thursday, June 25, 2020. We will certainly contact you with more details closer to the camp date. Any special needs, please let us know and we will try our best to accommodate.
Your answer
Please fill out the Parental Consent Forms needed to finish the application process for Echo Chicago 2020. Please expect the hard copy of the Parental Consent Form via: *
Not including a possible shuttle service, the regular price will be $399.00. Please expect my payment via: *
There will be a $25.00 fee for the linens provided by Saint Xavier University. (Included in the linen package are: mattress cover, linen blanket, pillow, pillow case, and a set of towels)
Comment
Your answer
Congratulations! You have completed the application form. BUT you are not done yet! Please send in your Parental Consent Form and make sure to pay your registration fee to complete the registration process.
This application form will be removed from our list if your Registration Form/Parental Consent Form and Payment have not been turned in at least one week after submitting this application form. If you have further questions, please email rpingoy@archchicago.org or call our office at 312-534-5355.
The Credit Card Payment option will be available soon.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy