Group List

Date Billing First name Billing Last name Billing Company Billing E-mail Billing Phone Billing City Billing State Variation Order Qty Total _billing_diocese
2023-02-24KarrieSteinhartSt. Rose of Lima School[email protected]608-744-2120Cuba CityWI20Diocese of Madison
2022-10-18MaryBlytheSt. Agnes[email protected]412-996-2115North HuntingdonPA17Greensburg
2022-10-17AmyBlanchetteSt. Anthony of Padua[email protected]2173246969EffinghamIL14Springfield, Illinois
2022-10-06ArleneTennerImmaculate Conception Church[email protected]715-222-2643New RichmondWI23Superior
2022-10-05TomBlommeArchangels Catholic Cluster[email protected]641-494-9540Forest CityIA34Dubuque
2022-10-05JenetteTeranSt. Francis Xavier Parish, St. Joh of the Cross, St. Cletus[email protected]217-994-0372La GrangeIL36Archdiocese of Chicago
2022-10-05ElliceBedelSt. Susanna Catholic Church[email protected]3174370543PlainfieldIN6Archdiocese of Indianapolis
2022-10-05LindaSteinmillerSS. Peter and Paul Parish[email protected]410-822-6581EASTONMD27Wilmington, DE
2022-10-03JillOrbanCatholic Church of St. Ann[email protected]6785958231MariettaGA58Atlanta
2022-10-03ShellyMombourquetteSt. Patrick[email protected]508-234-5656WhitinsvilleMA17Worcester
2022-10-02MichelleLutterOur Lady of the Lake[email protected]978-855-4513Leominster,MA16Worcester

Total quantity sold : 268

Email selected customers

Contact Leader's NameParish/Youth GroupCamp AttendingVehicle 1 - Type of VehicleVehicle 1 - Driver's NameVehicle 1 - Insurance CompanyVehicle 1 - Number of SeatbeltsAdd second vehicle?Vehicle 2 - Type of VehicleVehicle 2 - Driver's NameVehicle 2 - Number of SeatbeltsVehicle 2 - Insurance CompanyAdd third vehicle?Vehicle 3 - Type of VehicleVehicle 3 - Driver's NameVehicle 3 - Number of SeatbeltsVehicle 3 - Insurance CompanyAdd fourth vehicle?Vehicle 4 - Type of VehicleVehicle 4 - Driver's NameVehicle 4 - Number of SeatbeltsVehicle 4 - Insurance CompanyAdd fifth vehicle? Vehicle 5 - Type of VehicleVehicle 5 - Driver's NameVehicle 5 - Number of SeatbeltsVehicle 5 - Insurance CompanyAdd sixth vehicle?Vehicle 6 - Type of VehicleVehicle 6 - Driver's NameVehicle 6 - Number of SeatbeltsVehicle 6 - Insurance CompanyAdd seventh vehicle?Vehicle 7 - Type of VehicleVehicle 7 - Driver's NameVehicle 7 - Number of SeatbeltsVehicle 7 - Insurance CompanyAdd eighth vehicle?Vehicle 8 - Type of VehicleVehicle 8 - Driver's NameVehicle 8 - Number of SeatbeltsVehicle 8 - Insurance CompanyAdd ninth vehicle?Vehicle 9 - Type of VehicleVehicle 9 - Driver's NameVehicle 9 - Number of SeatbeltsVehicle 9 - Insurance CompanyDeparture Date & TimeDeparture City & CodeDeparture Airline & Flight #Do you have a connecting flight for this trip?Connecting City & CodeConnecting Airline & Flight #Connecting Date / TimeArrival Date & TimeDeparture Date & Time (End of Week)Departure Airline & Flight # (End of Week)After the free day, will you be returning to the school stay the night?Number of People Traveling?CommentsContact Leader EmailEntry IDSequence NumberEntry DateDelete Entry Link
I am completing this Verification Form for my _______________ Camp AttendingName of ParishName of GroupPlease list the names of all adults attending (18+ at the time of camp)Verification Agreement: ParishVerification Agreement: CommunityContact Leaders NameContact Leader's SignatureContact Leader's EmailPastor's NamePastor's SignatureAre there any policies your group must follow as established by your diocese?Please explainEntry IDSequence NumberEntry DateDelete Entry Link
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Camper Paperwork (AKA Applications)

Participant NameNicknameParish / GroupHave you attended CHWC before?How many years?GenderShirt SizeAge Category (at the time of camp)Grade entering in the fall of 2023Cell PhoneEmailFirst Choice Service AssignmentSecond Choice Service AssignmentConstruction:Concrete/Masonry:Drywall:Painting:Plumbing:Electrical:Any comments to help place you on a team?Are there any health issues we need to know about before placing you at a worksite?Other Jobs at CampParticipant Date of BirthEmergency ContactEmergency Contact, Relationship to ParticipantEmergency Contact, Phone NumberHealth Status: Please list any health problems you may havePlease list all medications taken routinely (over the counter and prescription)Physician NamePhysician Phone NumberDate of your last Tetanus BoosterHealth Insurance: ProviderHealth Insurance: Policy NumberHealth Insurance: Group NumberRELEASE OF ALL CLAIMSMEDIA WAIVERCODE OF BEHAVIORParticipant SignatureCustodial Parent NameCustodial Parent SignatureCustodial Parent EmailSIGNATURE AGREEMENTAre you a member of clergy or professed religious?Please SpecifyEntry IDSequence NumberEntry DateDelete Entry Link
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