REGISTER FOR A LOCAL MISSION

REGISTER FOR A LOCAL MISSION

501 Belmont Ave Folsom, PA 19033
CHOOSE YOUR MISSION!*

November 9th - Sacred Heart Parish MissionDecember 14th - Coatesville Mercy MissionNovember 16th - Christ the King! Kensington Mercy Mission
Mission$
Please enter your Name*

First NameLast Name
Email
Phone*
Birth date*

MonthDayYear
We hope there will be no emergencies, but just in case, what is the name of a Parent/Guardian/Emergency Contact?*

First NameLast Name
Parent/Guardian/Emergency Contact email:*
Parent/Guardian/Emergency Contact Cell Phone Number:*
DO YOU AGREE TO THE TERMS?

By agreeing you certify that as a parent/guardian (if the above registrant is under 18) or adult registrant (if over 18) you have read and agree to all the terms included in the here referenced RC Activities Inc. waivers and that by entering your name below your agreement to these terms is binding in a court of law. (If under 18 CLICK HERE). (if over 18 CLICK HERE).

I have read and understand the above permission form in its entirety, and also understand that it is a legal document and I agree and consent to all terms and conditions contained within.
I have read and understand the above permission form in its entirety, and also understand that it is a legal document and I agree and consent to all terms and conditions contained within. Type your first and last name:*
Do you have a Mission Youth T-shirt or hoodie? (T-Shirt: $15) (Hoodie: $35) The Missionary Uniform: Mission Youth t-shirt or hoodie, jeans, and closed-toed shoes. No flip flops, thin-sole shoes, leggings, shorts. Please respect our dress code. Choose as many as you like!*

No thanks, I already have oneXS T-ShirtS T-ShirtS T-ShirtM T-ShirtM T-ShirtL T-ShirtL T-ShirtXL T-ShirtXL T-ShirtXXL T-ShirtXXL T-ShirtS HoodieS HoodieM HoodieM HoodieL HoodieL HoodieXL HoodieXL HoodieXXL HoodieXXL Hoodie
Shirt$
If you have a scholarship code please enter it here:
Scholarship$
Calculation

Great! We're so excited to have you. Here's the total:

USDMission Registration Amount

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty: