Manager Dashboard: North Haledon, NJ - Catholic HEART Workcamp

Group List

North Haledon

Date	Billing First name	Billing Last name	Billing Company	Billing E-mail	Billing Phone	Billing City	Billing State	Order Qty Total	_billing_diocese
2023-01-17	Quinn	Furnald	Notre Dame of Mt. Carmel	[email protected]	9087970170	Cedar Knolls	NJ	15	Paterson
2023-01-09	Angela	Seman	Holy Spirit Parish	[email protected]	724-657-7937	New Castle	PA	7	Pittsburgh
2022-12-28	Dan	Doyle	St Anne-St Patrick	[email protected]	5083479353	Fiskdale	MA	11	Worcester
2022-10-12	Susan	Gallivan	St. Richard Parish	[email protected]	9784228881	Sterling	MA	8	Worcester
2022-10-06	Courtney	Callanan	The Holy Rood Collaborative	[email protected]	978-256-2374	N. Chelmsford	MA	17	Boston
2022-10-05	Rebecca	Grant Jenkins	Our Lady Queen of Peace Catholic Church	[email protected]	7039795580	Arlington	VA	18	Arlington
2022-10-05	Sarah	Beaver	Our Lady of Peace	[email protected]	8148066041	Erie	PA	34	Erie
2022-10-05	Jennifer	Frericks	St. Jude Parish	[email protected]	2174989197	Rochester	IL	16	Springfield Illinois
2022-10-05	Robert	Ferretti	St. Joseph's Parish (NJ)	[email protected]	9177102051	Hillsborough	NJ	36	Metuchen
2022-10-03	Fr. Paul	Castellani	St. Philomena	[email protected]	2158015434	Lansdowne	PA	20	Philadelphia

Total quantity sold : 182


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Transportation Forms

Contact Leader's Name	Parish/Youth Group	Camp Attending	Vehicle 1 - Type of Vehicle	Vehicle 1 - Driver's Name	Vehicle 1 - Insurance Company	Vehicle 1 - Number of Seatbelts	Add second vehicle?	Vehicle 2 - Type of Vehicle	Vehicle 2 - Driver's Name	Vehicle 2 - Number of Seatbelts	Vehicle 2 - Insurance Company	Add third vehicle?	Vehicle 3 - Type of Vehicle	Vehicle 3 - Driver's Name	Vehicle 3 - Number of Seatbelts	Vehicle 3 - Insurance Company	Add fourth vehicle?	Vehicle 4 - Type of Vehicle	Vehicle 4 - Driver's Name	Vehicle 4 - Number of Seatbelts	Vehicle 4 - Insurance Company	Add fifth vehicle?	Vehicle 5 - Type of Vehicle	Vehicle 5 - Driver's Name	Vehicle 5 - Number of Seatbelts	Vehicle 5 - Insurance Company	Add sixth vehicle?	Vehicle 6 - Type of Vehicle	Vehicle 6 - Driver's Name	Vehicle 6 - Number of Seatbelts	Vehicle 6 - Insurance Company	Add seventh vehicle?	Vehicle 7 - Type of Vehicle	Vehicle 7 - Driver's Name	Vehicle 7 - Number of Seatbelts	Vehicle 7 - Insurance Company	Add eighth vehicle?	Vehicle 8 - Type of Vehicle	Vehicle 8 - Driver's Name	Vehicle 8 - Number of Seatbelts	Vehicle 8 - Insurance Company	Add ninth vehicle?	Vehicle 9 - Type of Vehicle	Vehicle 9 - Driver's Name	Vehicle 9 - Number of Seatbelts	Vehicle 9 - Insurance Company	Departure Date & Time	Departure City & Code	Departure Airline & Flight #	Do you have a connecting flight for this trip?	Connecting City & Code	Connecting Airline & Flight #	Connecting Date / Time	Arrival Date & Time	Departure 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?	Comments	Contact Leader Email	Entry ID	Sequence Number	Entry Date	Delete Entry Link

Verification Agreements

I am completing this Verification Form for my _______________	Camp Attending	Name of Parish	Name of Group	Please list the names of all adults attending (18+ at the time of camp)	Verification Agreement: Parish	Verification Agreement: Community	Contact Leaders Name	Contact Leader's Signature	Contact Leader's Email	Pastor's Name	Pastor's Signature	Are there any policies your group must follow as established by your diocese?	Please explain	Entry ID	Sequence Number	Entry Date	Delete Entry Link

Clergy (letters of suitability)

Name	Email	Camp (City) Attending	Church/Parish	Comments	Please upload your letter of suitability below	Entry ID	Sequence Number	Entry Date	Delete Entry Link

Release Forms: Host YG / Volunteers

Name	Nickname	Gender	Age Category (at the time of camp)	Grade entering in the fall of 2023	Cell Phone	Email	Participant Date of Birth	Emergency Contact	Emergency Contact, Relationship to Participant	Emergency Contact, Phone Number	Health Status: Please list any health problems you may have	Please list all medications taken routinely (over the counter and prescription)	Physician Name	Physician Phone Number	Date of your last Tetanus Booster	Health Insurance: Provider	Health Insurance: Policy Number	Health Insurance: Group Number	RELEASE OF ALL CLAIMS	MEDIA WAIVER	Participant Signature	Custodial Parent Name	Custodial Parent Signature	Custodial Parent Email	SIGNATURE AGREEMENT	Are you a member of clergy or professed religious?	Please Specify	Parish / Group	Camp	Entry ID	Sequence Number	Entry Date	Delete Entry Link

Camper Paperwork (AKA Applications)

Participant Name	Nickname	Parish / Group	Have you attended CHWC before?	How many years?	Gender	Shirt Size	Age Category (at the time of camp)	Grade entering in the fall of 2023	Cell Phone	Email	First Choice Service Assignment	Second Choice Service Assignment	Construction:	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 Camp	Participant Date of Birth	Emergency Contact	Emergency Contact, Relationship to Participant	Emergency Contact, Phone Number	Health Status: Please list any health problems you may have	Please list all medications taken routinely (over the counter and prescription)	Physician Name	Physician Phone Number	Date of your last Tetanus Booster	Health Insurance: Provider	Health Insurance: Policy Number	Health Insurance: Group Number	RELEASE OF ALL CLAIMS	MEDIA WAIVER	CODE OF BEHAVIOR	Participant Signature	Custodial Parent Name	Custodial Parent Signature	Custodial Parent Email	SIGNATURE AGREEMENT	Are you a member of clergy or professed religious?	Please Specify	Entry ID	Sequence Number	Entry Date	Delete Entry Link

Via Louisville (AKA Applications)

Participant Name	Nickname	Parish / Group	Have you attended CHWC before?	How many years?	Gender	Shirt Size	Age Category (at the time of camp)	Grade entering in the fall of 2023	Cell Phone	Email	First Choice Service Assignment	Second Choice Service Assignment	Construction:	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 Camp	Participant Date of Birth	Emergency Contact	Emergency Contact, Relationship to Participant	Emergency Contact, Phone Number	Health Status: Please list any health problems you may have	Please list all medications taken routinely (over the counter and prescription)	Physician Name	Physician Phone Number	Date of your last Tetanus Booster	Health Insurance: Provider	Health Insurance: Policy Number	Health Insurance: Group Number	RELEASE OF ALL CLAIMS	MEDIA WAIVER	CODE OF BEHAVIOR	Participant Signature	Custodial Parent Name	Custodial Parent Signature	Custodial Parent Email	SIGNATURE AGREEMENT	Are you a member of clergy or professed religious?	Please Specify	Entry ID	Sequence Number	Entry Date	Delete Entry Link

Camp Evaluations

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