Muncie catholic

A PASTORATE OF THE DIOCESE OF
LAFAYETTE-IN-INDIANA

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NCYC Chaperone Registration

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  Chaperone Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parish REQUIRED Please fill out this field.
  
  I am registering for: Conference with hotel option (4 person room) Conference with hotel option (2 person room; additional cost) Conference with commuter option. I understand I am responsible for transportation.
  
  Agreement
  
  I understand that a $100 non-refundable deposit is required to hold my spot.
  
  Checks should be written to St. Mary. Full payment is due by September 10, 2023.
  I Agree Please select this field.
  
  I understand that I must be compliant with all diocesan Safe & Sacred requirements prior to attending NCYC.
  I Agree Please select this field.
  
  Today's Date REQUIRED Please fill out this field. Please enter a date.
  
  Submit
  
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