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H.S. Youth Mission Trip 2025 Registration

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Staff Contact
- Grace Martinez
  
  Coordinator of Youth Ministry
  
  513-489-8815 x737
  grace.martinezgood-shepherd.org

H.S. Mission Trip 2025
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- CATHOLIC HEART WORKCAMP
  CHWC offers short-term mission trips for Catholic youth groups. We provide everything you need for an unforgettable experience. Catholic HEART Workcamp faithfully and enthusiastically serves the Catholic Church and its teachings and is an excellent opportunity to “love the least of these.”
  
  Each day begins with a wake-up call at 6:15 am, followed by breakfast. The morning program will consist of daily mass and, some days, a short testimony by a staff member. You will be at your worksite from around 9 am to 3 pm. Your day consists of repairing and renewing homes by (but not limited to) painting, house cleaning, yard work, basic construction projects, and/or helping build new homes for low-income families through organizations such as Habitat for Humanity. Other work projects will include helping at daycare centers for low-income families and/or helping at Social Service Centers (food pantries, homeless shelters, etc.). You may or may not be at the same location for the whole week; it depends on the project, weather conditions, and duration of work.
  
  While at your worksite, you will break for lunch each day and have a Prayer/Share time where you will go over discussion questions, explore the Catholic faith, and get to know your team on a deeper level.
  
  After arriving back at the school, there will be free time for showers, relaxation, socializing, etc. Group leaders are responsible for their own campers during free time. Then, everyone will have an evening program. The first half of each evening program will include fun games and upbeat music, and then we will transition into a more prayerful time with skits, videos, talks, praise and worship, and other opportunities to deepen one’s faith and reflect on the day’s activities.
  
  LEARN MORE
  
  Details
  Who: H.S. students (rising 9th – 12th graders)
  What: Youth Mission Trip – Catholic Heart Workcamp
  When: Sunday, June 15, 2025 at 9:30 a.m. to Friday, June 20 at 11:00 p.m.
  Where: Richmond, VA | We will stay at 12829 River Road, Richmond, VA 23238
  Cost: $200
- Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Father's Name Please enter valid data.
- Mother's Name Please enter valid data.
- Street Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Home Phone Number Maximum 20 characters Please enter a phone number.
- Dad's Cell Phone Number Maximum 20 characters Please enter a phone number.
- Mom's Cell Phone Number Maximum 20 characters Please enter a phone number.
- Primary Email REQUIRED Please fill out this field. Please enter an email address.
- Are you a registered member of Good Shepherd? REQUIRED Yes No Please fill out this field.
- How many high schoolers would you like to register for Catholic Heart Workcamp 2025? Please fill out this field.
  
  Name of High Schooler 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level (as of summer of 2025) REQUIRED Please fill out this field. Please enter an integer (number).
  
  School District REQUIRED Please fill out this field. Please enter valid data.
  
  Sex
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  FEE
  
  Fee per person200.0
  
  MEDICAL INFORMATION
  
  Please list allergies (e.g. food, drugs, anesthetics). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list medications taken regularly. If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list any conditions/impairments (e.g. epilepsy, diabetes, asthma). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Name of High Schooler 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level (as of summer of 2025) REQUIRED Please fill out this field. Please enter an integer (number).
  
  School District REQUIRED Please fill out this field. Please enter valid data.
  
  Sex
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  FEE
  
  Fee per person200.0
  
  MEDICAL INFORMATION
  
  Please list allergies (e.g. food, drugs, anesthetics). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list medications taken regularly. If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list any conditions/impairments (e.g. epilepsy, diabetes, asthma). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Name of High Schooler 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level (as of summer of 2025) REQUIRED Please fill out this field. Please enter an integer (number).
  
  School District REQUIRED Please fill out this field. Please enter valid data.
  
  Sex
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  FEE
  
  Fee per person200.0
  
  MEDICAL INFORMATION
  
  Please list allergies (e.g. food, drugs, anesthetics). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list medications taken regularly. If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list any conditions/impairments (e.g. epilepsy, diabetes, asthma). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Name of High Schooler 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level (as of summer of 2025) REQUIRED Please fill out this field. Please enter an integer (number).
  
  School District REQUIRED Please fill out this field. Please enter valid data.
  
  Sex
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  FEE
  
  Fee per person200.0
  
  MEDICAL INFORMATION
  
  Please list allergies (e.g. food, drugs, anesthetics). If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list medications taken regularly. If this does not apply, please write "NA." REQUIRED Please fill out this field.
  
  Please list any conditions/impairments (e.g. epilepsy, diabetes, asthma). If this does not apply, please write "NA." REQUIRED Please fill out this field.
- FAMILY DOCTOR
- What is the name of your family doctor? REQUIRED Please fill out this field. Please enter valid data.
- Phone number for your family doctor. REQUIRED Please fill out this field. Please enter valid data.
- #1 EMERGENCY CONTACT
- List Emergency Contact (other than parents).
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship Please enter valid data.
- Phone Number Maximum 20 characters Please enter a phone number.
- #2 EMERGENCY CONTACT
- List Emergency Contact (other than parents).
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship Please enter valid data.
- Phone Number Maximum 20 characters Please enter a phone number.
- Archdiocese of Cincinnati youth permission form for H.S. Mission Trip 2025.
  Service dates: Sunday, June 15, 2025 at 9:30 a.m. to Friday, June 20 at 11:00 p.m.
  Please download, read and retain the Archdiocese of Cincinnati Permission, Release and Authorization to Seek Medical Treatment form for your records ►
- I have read and agree to the Archdiocese of Cincinnati Permission, Release and Authorization to Seek Medical Treatment form that has been provided in the block above. REQUIRED Yes No Please fill out this field.
- PHOTO PERMISSION
  I understand that Good Shepherd’s Faith Formation staff may take photos and videos during activities for the purpose of promoting the programs via our website, Sunday bulletin, parish social media page (for example, Facebook, Twitter, Instagram), or news releases to local or diocesan papers. I give my permission for pictures that are taken of my family, adults and children, to be used for this purpose.
- I have read and agree to the Photo Permission statement listed above. REQUIRED Yes No Please fill out this field.
- Please be aware that we will continue to follow the guidelines of the Archdiocese of Cincinnati regarding social distancing and other precautions due to the COVID-19 pandemic. We appreciate your patience and flexibility in the event changes need to be made.
- I have read and understand that we are following all Archdiocesan Guidelines related to the pandemic, and if changes occur with the pandemic we will adjust accordingly. REQUIRED Yes, I have read and agree to the statement above regarding the pandemic. Please fill out this field.
- By clicking on the "I Agree" box, it will serve as your digital signature for this submission.
  I Agree Please select this field.
- If you would like to share any additional information, please do so in the box below.
- Name of Custodial Parent/Legal Guardian REQUIRED Please fill out this field. Please enter valid data.
- Please type your initials below. REQUIRED Please fill out this field. Please enter valid data.
- Today's Date REQUIRED Please fill out this field. Please enter a date.
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