June 24- July 2, 2023 Registration FormPiura, Peru Mission TripDennis J O’Connell High School First name * (as shown on passport) Middle name * (as shown on passport) Last name * (as shown on passport) Birthdate * MM DD YYYY Age * Gender * Female Male Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### T-Shirt Size * (adult sizes only) S M L XL 1st Parent/Guardian Name * First Name Last Name 1st Parent/Guardian Email * 1st Parent/Guardian Cell * (###) ### #### 2nd Parent/Guardian Name * 2nd Parent/Guardian Email * 2nd Parent/Guardian Cell * (###) ### #### Your Parish Health Concerns * Do you have any health concerns that we should know about? This will not exclude you from consideration. Indicate N/A if none. Agreement * Participation in a CBC mission trip involves practical, spiritual and catechetical preparation. As a CBC missionary, you will be expected to attend the two 1/2 day mission retreats and one 1/2 day service project with the rest of the team. By registering you agree to opt in to communications from Commissioned By Christ. Balances due for mission trips will be invoiced for payment directly to your parent. Please indicate below that you understand this requirement. Yes, I confirm that I understand and agree. No, I do not agree. Thank you for your registration and for answering the call to serve those in need! Your mission team leaders will be in contact with you soon.
