CROSS Middle School Trip 2026

Contact Information

Name of YOUTH

Name of Parent(s)

Grade for 2025-2026 school year

Youth Birthday

Contact Email of Parent/Guardian

This address will receive a confirmation email

Parent/Guardian Phone

Emergency Contact Name

Emergency Contact Phone

Health Information

Does your youth have any allergies?

Does your youth have any dietary restrictions?

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

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

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

July 12-17

Register here for the middle school mission trip, CROSS 2026.
Early bird registration: $500 if you register before January 1, 2026
Final registration: $550, Registration closes May 1, 2026

CROSS Middle School Trip 2026

Description

Please Fix the Following