Fall Camping Registration

Please note you will need to pay in person with Ms. Noelle at the St. JPII Newman Center

Fall Camping Trip Registration Form

* Indicates required field

Name *

First

Last

Email *

Phone Number *

College or University *

Year in School *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Local Address *

Line 1

Line 2

City

State

Zip Code

Country

Emergency Contact Name & Relationship *

First

Last

Emergency Contact Phone Number *

Do You Have Any Special Needs (Dietary, Handicap Facilities, Allergies, Etc.)? *

Do You Have A Tent That You Would Be Willing To Bring? *

Yes No

If Yes, How Many People Does Your Tent Hold? *

Submit