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
2023-04-25JessicaSmithCatholic Church of the Epiphany[email protected]386-767-6111Port OrangeFL14Orlando
2022-10-05MikeYoungQuincy Notre Dame High School[email protected]2176176632QuincyIL79Springfield, IL
2022-10-04SusanRaboldSt. Paul the Apostle Catholic Church[email protected]336-210-0843GreensboroNC25Charlotte
2022-10-03St. LouisYouth MinistrySt. Louis Catholic Church[email protected]901-255-1965MemphisTN59Memphis

Total quantity sold : 177

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 VehicleAdd eighth vehicle?Vehicle 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
No records found
No records found

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
No records found