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Mission Trip Registration

- Thank you for your interest in our
  2026 Summer Mission Trip
  Saint Anne partners with Catholic Heart Workcamp to offer a week-long summer mission trip for incoming high school freshman through current college freshmen. The mission is to revitalize communities and beautify homes for the elderly, disabled and those who cannot afford needed repairs. This experience will empower participants to live as disciples of Christ through serving others and foster the spiritual growth of each participant through the sacraments, Catholic faith sharing and prayer. Note: During the week your child may be paired with teens|adults from other parishes and driven to other site locations.
  
  Date: June 14-19, 2026
  Cost: $650.00
  Registration deadline: May 14, 2026 | No Refunds After April 14, 2026
  Home Base Location: University of Saint Francis-Fort Wayne, IN
  2701 Spring Street, Fort Wayne, IN 46808
  
  There are three components that are required to participate in our 2026 Summer Mission Trip:
  1) Saint Anne CC Youth & Young Adult Participant Information and Agreement; (Complete this form)
  2) Full Payment Received: (Complete this form, click "Proceed to Payment" and complete/submit full payment.)
  3) Catholic Heart Workcamp Registration and Waiver - Click Here (Select "Fort Wayne, IN (University of St Francis)" for the camp and "Saint Anne - Barrington, IL" for the group.
  
  This online registration is payable by Credit Card and ACH payment only. If you choose to register and pay offline, please contact the Youth and Young Adult Ministry office at [email protected] for registration information and payment form.
  
  Questions? Contact Amy Hodson at [email protected] or 847-620-3073 for more information.
- Required Read:
  Archdiocese of Chicago
  Permission & Agreement
- Registration Form:
  
  This form is not accepting responses at this time.
  
  CHILD INFORMATION:
  
  Child's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address where child participant resides 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.
  
  Child's Cell Number (include dashes) REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Email Address REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Choose One REQUIRED Please fill out this field.
  
  Child's High School REQUIRED Please fill out this field. Please enter valid data.
  
  H.S. Graduation Year REQUIRED Please fill out this field.
  
  Child's Home Parish|Church REQUIRED Please fill out this field. Please enter valid data.
  
  PARENT|GUARDIAN 1 INFORMATION:
  
  Parent|Guardian 1 First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent|Guardian 1 Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent|Guardian 1 Relationship to Child - Example: Mother, Father, etc. REQUIRED Please fill out this field. Please enter valid data.
  
  Parent|Guardian 1 Cell Number (include dashes) REQUIRED Please fill out this field. Please enter valid data.
  
  Parent|Guardian 1 Email Address REQUIRED Please fill out this field. Please enter an email address.
  
  PARENT|GUARDIAN 2 INFORMATION:
  
  Parent|Guardian 2 First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent|Guardian 2 Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent|Guardian 2 Relationship to Child - Example: Mother, Father, etc. REQUIRED Please fill out this field. Please enter valid data.
  
  Parent|Guardian 2 Cell Number (include dashes) REQUIRED Please fill out this field. Please enter valid data.
  
  Parent|Guardian 2 Email Address REQUIRED Please fill out this field. Please enter valid data.
  
  IN THE EVENT THE PARENT|GUARDIAN CAN'T BE REACHED, WHO SHALL WE CONTACT?
  
  Emergency Contact First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Phone Number (include dashes) REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to Child: - Example: Grandfather, Grandmother, Neighbor etc. REQUIRED Please fill out this field. Please enter valid data.
  
  CHILD PARTICIPANT HEALTH INFORMATION:
  
  Child Participant Allergies and or Dietary Restrictions: NA or None if not applicable REQUIRED Please fill out this field. Please enter valid data.
  
  Child Participant Current Medication[s]: NA or None if not applicable REQUIRED Please fill out this field. Please enter valid data.
  
  Any Additional Information You'd Like Us to Know About Your Child Participant: NA or None if not applicable REQUIRED Please fill out this field. Please enter valid data.
  
  Name of Child Participant Physician:
  
  Physician First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Phone Number (include dashes) REQUIRED Please fill out this field. Please enter valid data.
  
  Medical Insurance Policy in the Name Of:
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Medical Insurance Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Medical Insurance I.D. Number REQUIRED Please fill out this field. Please enter valid data.
  
  PERMISSIONS:
  
  Retreat Code of Conduct:
  Rules of Behavior for Students:
  Attend all scheduled activities.
  Will not smoke, vape, engage in the use of alcohol, drugs, and weapons nor have them in my possession.
  Will treat all staff, chaperones and fellow participants with respect at all times.
  Will treat the facilities and grounds with respect at all times.
  Will abide by any and all additional Rules expressed by the chaperones or Camp staff.
  Consequences of Not Abiding by the Rules:
  For behavioral infractions or breaking of rules, warning will be given and the participant will have the opportunity to change the problematic behavior. If the problematic behavior continues, the participant will be asked to contact their parents to arrange to return home immediately.
  If the participant uses alcohol or drugs during the event, even if they are not the one to bring them, they will be asked to contact their parent|guardian to arrange to return home immediately.
  
  I Agree - Code of Conduct REQUIRED Parent|Guardian: Yes - I Agree - Code of Conduct Child Participant: Yes - I Agree Code of Conduct Please fill out this field.
  
  As shown above, I have read and understand the Archdiocese of Chicago Permission Form and Participant Agreement, and I agree to abide by it. REQUIRED Parent|Guardian: Yes - I Agree - Archdiocese of Chicago Permission Form and Participant Agreement Child Participant - Yes - I Agree, - Archdiocese of Chicago Permission Form and Participant Agreement Please fill out this field.
  
  I understand my child participant will be transported to and from University Of Saint Francis-Fort Wayne-2701 Spring Street, Fort Wayne, IN 46808 and Saint Anne CC, 120 Ela St, Barrington, IL 60010. As well as making several stops along the way for things such as gas, food, and extra activities.
  
  I Agree - Transportation REQUIRED Yes - I Agree Transportation Please fill out this field.
  
  I give permission for my child participant to receive email and text communication from Saint Anne Catholic Community, Barrington, IL Youth and Young Adult Ministry REQUIRED Yes - I Agree - Permission for child participant to receive email and text communication Please fill out this field.
  
  Digital Signatures:
  
  Parent|Guardian: Digital Signature (Please type first and last name) REQUIRED Please fill out this field. Please enter valid data.
  
  Date REQUIRED Please fill out this field. Please enter a date.
  
  Child Participant: Digital Signature (Please type first and last name) REQUIRED Please fill out this field. Please enter valid data.
  
  Date REQUIRED Please fill out this field. Please enter a date.
  
  Summer Mission Trip 2026 Registration Fee650.0
  
  Would you like to help offset online payment processing fees? REQUIRED
  3.00% for Credit Cards; 1.0% for ACH charges
  Yes, I can help - Credit Card only Yes, I can help - ACH only No, I do not wish to offset the online processing fee Please fill out this field.
  
  Total:
  
  Submit
  
  Proceed to Payment

Mission Trip Registration

Thank you for your interest in our

2026 Summer Mission Trip

Date: June 14-19, 2026

Cost: $650.00

Registration deadline: May 14, 2026 | No Refunds After April 14, 2026

Home Base Location: University of Saint Francis-Fort Wayne, IN

2701 Spring Street, Fort Wayne, IN 46808