Parent or Guardian Information: In the event of an emergency, if your emergency contact cannot be reached by the number provided, Chrysalis staff has permission to secure the services of licensed medical professionals to provide the care necessary, including anesthesia. By signing this application, you are giving permission to Southern Ohio Chrysalis to list your child's name on the Southern Ohio Chrysalis website for prayer support purposes. Please mail a $30.00 registration deposit to our registrar at 2006 Baird Avenue, Portsmouth OH, 45662. This is to be applied to the total $60.00 cost of the flight. This deposit is nonrefundable. Please make your check payable to SOUTHERN OHIO CHRYSALIS.