Sight and Sound Youth Group Trip

David

Cost: $120 per person (ticket and bus)

First come first serve.

Your reservation won't be held until a $30 non-refundable deposit per person is submitted.

Check payable to "St Jude Parish" or payable online at Saint Jude Parish: Online Giving (stjc.org) (If paying online, choose Youth Group Trip in pulldown menu)

**Please complete this form as well as the Hold Harmless Agreement and pay the deposit**

Personal Info

Name

First Name

Last Name

Address

Street 1

Street 2

City

State

Zip

Your Phone

E-mail

Name of Parent(s)/Legal Guardian(s)

First Name

Last Name

Phone of Parent(s)/Legal Guardian(s)

Medical Information

Emergency Contact Information

Name

First Name

Last Name

Address

Street 1

Street 2

City

State

Zip

Home Phone

Work Phone

Cell Phone

Cost

Shopping Basket

		Quantity	Extended