Mission Week

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Parent Email REQUIRED Please fill out this field. Please enter an email address.

Teen Email Please enter an email address.

Phone Number Please enter a phone number.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Current Grade REQUIRED

Must be in 9th grade or above to register for Mission Week

Please fill out this field.

Current School REQUIRED Please fill out this field. Please enter valid data.

T-Shirt Size REQUIRED

Sizes are adult shirt sizes

Please fill out this field. Please enter valid data.

June 19-June 24, 2022 - I have checked these dates and marked them on my calendar to avoid scheduling conflicts.

I Agree Please select this field.

I understand that the balance (if any) of the total fee is due no later than May 15, 2022. If paying by check, please make them payable to St. Catherine Labouré.

I Agree Please select this field.

I understand that there may be additional fees for this trip.

I Agree Please select this field.

I understand that to qualify for this trip I must fill out the Teen Application Form, the Code of Behavior Form, (these forms will be given to you in early May) and attend 3 Youth Group activities. It's important that we all know each other. This is an amazing week and knowing the group makes it an even better experience!

I Agree Please select this field.

Payment/Deposit Options REQUIRED 100.0 – Deposit (check) 103.9 – Deposit (credit card) 250.0 – Balance (check) 260.0 – Balance (credit card) 350.0 – Total Fee (check) 364.0 – Total Fee (credit card) Please fill out this field.

A Note Before Paying:

You will be redirected to the payment page once you click "proceed to payment." If you get a message that your session timed out, please do not fill out a new form and submit another payment. There seems to be some time delay in some institutions processing payments. The payment message sends out automatically to you if it doesn't get an "approved" indicator from the institution immediately. Please contact Jason to verify your submission before "re-paying"

St. Catherine Labouré Parish

St. Joan of Arc Church &
St. Louise de Marillac Church

Mission Week

Registration and Payment Form - Mission Week 2022

A Note Before Paying: