CROSS Middle School Trip 2025

July 13th- 18th | Register here for the middle school mission trip, CROSS 2025.
Early bird registration: $500 if you register before January 1, 2025
Final registration: $550, Registration closes May 1

Contact Information

Name of YOUTH

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Grade for 2024-2025 school year

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Name of Parent(s)

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Contact Email of Parent

*

This address will receive a confirmation email

Parent Phone

*

Emergency Contact Name

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Emergency Contact Phone

*

T-Shirt Size

*

Please select one option.

YS YM YL S M L XL XXL

Health Information

Does your youth have any allergies?

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Does your youth have any dietary restrictions?

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Does your youth take any prescription drugs? If so please list name, dose, and frequency.

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Is there any other medical information relevant for your child? (Lingering injuries, mental health, recent surgeries, ongoing medical issues, etc.)

*

Health Insurance Company

*

Policy Number

*

Payment

deposit ($150) pay in full ($500) scholarship (0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

July 13th- 18th

Register here for the middle school mission trip, CROSS 2025.
Early bird registration: $500 if you register before January 1, 2025
Final registration: $550, Registration closes May 1

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