Mission Trip 2021
Register here by November 12 for summer 2021 Mission Trip to Denver, CO from June 12-19, 202. Registrations will be taken after that date but your spot will not be guaranteed. More information on the prices and fund raising opportunities are available on the Youth Ministry website https://www.stjohn23rdyouth.org/mission-trip.html or by contacting Maureen at rotramelm@stjohn23rd.org. Please do not let financial constraints stop you or your family stop from participating in these life changing opportunities but please also recognize that we have bills to pay as well so we need your cooperation! We will be attending again through Catholic Heart Work Camp. More information can be found at https://www.stjohn23rdyouth.org/mission-trip.html or http://heartworkcamp.com/dates/
Name of participant *
Street address *
City *
School *
Please indicate what school you currently attend. For adult participants, just write adult or N/A
Grade *
Parent phone number *
If this is a cell phone number, do you want to receive text message reminders of events/due dates etc? *
Participant cell phone number
Does the student participant want to receive text reminders of events/due dates etc?
Clear selection
Email *
T-shirt size *
I understand that I will have to pay or fund raise a $50 deposit to secure my spot on the mission trip before the due date *
I have read the Teen Pledge and have discussed this with my teen participant. I support all the statements that my child is pledging to. I understand that I must communicate responsibilities and participation with my child. I will encourage my child to fulfill his/ her responsibilities to fundraise for program costs (travel, food, equipment, and camp fees) and I will be responsible financially if my child is unable to fundraise on his/her own. I understand that my child may be asked to leave the Mission Trip program if his/her responsibilities are not fulfilled, or if behavior is not cooperative and in line with our Catholic Formation Policies. Finally, I agree to support the Mission Trip as our young people take the leap of faith, to help serve our brothers and sisters locally, nationally and internatioanlly. I will take an active role in supporting the Mission Trip by being a chaperone, planning a fundraising event, being a fundraiser volunteer, or helping with other tasks as needed. I will pray for all involved and for the success of all the trips.

The ENTIRE cost of the trip is to be covered through student payments and fundraising. The cost of the trip usually ranges between $600 and $800 per student in the continental US (exact price depends on how many people participate. We should have a solid number once all the registrations are in.)

Payment/fundraising schedule is as follows: $50 deposit to guarantee your spot with online registration form due by November 12, 2020; 50% of total due by March 15, 2021; 75% due by April 15, 2021 and 100% of total due by May 15, 2021. NOTE: THERE WILL BE NO REFUNDS GIVEN AFTER MARCH 15, 2021

Please note that the camps fill up quickly, so the earlier we receive your registration form, the more secure your spot is! (We can only guarantee your spot if we receive your registration by November 12 – after that it will depend on camp availability.)

Mail or drop off your deposit at the youth ministry office, 1802 N Wisconsin, Port Washington, WI 53074. For questions or financial assistance, contact the youth ministry office . PLEASE MAKE ALL CHECKS PAYABLE TO “St. John XXIII” and indicate “mission trip” on memo line.
Signatures for Commitment for Payment & Participation

In signing below, we (participant and parent) have read and agreed to both the Parent and Teen Pledge of Commitment.

Parent Signature: By entering my full name, I attest that this constitutes my legal electronic signature on this form. *
Teen Signature: By entering my full name, I attest that this constitutes my legal electronic signature on this form. *
For adult participants please enter "Adult"
Date *
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