Resurrection Parish | Adults 18 yr. and up - Mission Trip Registration Form 2025

If you will be over age 18 by July 13, 2025, please fill out this registration form. Please note, this trip is ideally meant for our parish young people (under age 25), with an appropriate balance of adult supervision and expertise (construction, medical, etc.). We have limited space for adults. Once we reach the maximum, we will open a waiting list. Please contact Mary Swindal, 412-833-0031 x239, [email protected] if you have any questions.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Male Female Please fill out this field.

Birthday (Month/Day/Year) REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Address REQUIRED Please fill out this field. Please enter valid data.

Address 2 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.

Occupation Please enter valid data.

T-shirt Size (adult unisex) REQUIRED Please fill out this field.

Are you a member of Resurrection Parish? REQUIRED Yes No Please fill out this field.

How many times have you attended the summer Mission Trip with Resurrection Parish (formerly St. Thomas More)? REQUIRED Please fill out this field. Please enter valid data.

Have you ever worked with youth before? If so, in what capacity? REQUIRED Please fill out this field.

List any skills or talents you are willing to share: REQUIRED Please fill out this field.

Are you interested in assisting with daily Mass? REQUIRED No Eucharistic Minister Lector Altar Server Coordinator Please fill out this field.

Are you interested in assisting with music? If so, which instrument? REQUIRED Please fill out this field. Please enter valid data.

Are you interested in assisting with faith-based evening programs? REQUIRED Yes No Please fill out this field.

Are you interested in assisting with the planning of recreational events? REQUIRED Yes No Please fill out this field.

Are you 25 years old and able, experienced, and willing to drive a 12-passenger van? REQUIRED yes no Please fill out this field.

Expectations for all adults/young adults attending this trip include driving there and back with the teens in the rental vans (Sunday thru Friday). You are expected to mentor and oversee teens on the worksite, teach them how to use tools and follow worksite rules, help them establish relationships with the homeowners, and provide assistance to them throughout the week. It is also expected that you will supervise teens while on campus and attend all evening activities with the group.

If you are unable to meet these requirements, please list reasons below:

Reasons

Reasons why you cannot meet these requirements.

Agreements:

The Resurrection Youth Mission Trip has my permission to use my photograph publicly to promote the Resurrection Youth Mission Trip. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.
I understand that I am required to comply with all Diocesan Safe Environment Policies. I will check status of / complete my Safe Environment Clearance asap.
I have reviewed the Dates and Deadlines section of this website and I am able to attend all meetings.
By signing this form, I agree that I will complete any additional forms, comply with all parish program policies, attend mandatory meetings, and fulfill my assigned work tasks on the trip.
I understand that if I am unable to meet these requirements, I will be unable to participate in the mission trip.
I understand that this trip is a Youth focused Program, and that in choosing to be part of it, I agree to chaperone, lead, instruct, and encourage the teens in our Resurrection Parish group.

Agreements REQUIRED I accept all of the Agreements above. Please fill out this field.

Cost Expectations:

I understand the cost per person of this trip is $650, less my $50 deposit securing my spot payable online or via check made out to Resurrection Parish. I understand that I must fundraise or pay the remaining balance by 6/01/2025 with opportunities made available for fundraising throughout the year and a potential fund contribution up to $200 based on a $1 for $1 match on every dollar I raise towards my trip cost.
I understand the above expectations and consequences as they have been set forth by the staff of Resurrection Parish. I will obey these rules and any others made before and/or during the trip.

I understand and agree to the Cost Expectations REQUIRED Yes Please fill out this field.

Liability Release: In consideration for being accepted by Resurrection Parish for participation in this event, I do hereby release, forever discharge and agree to hold harmless Resurrection Catholic Parish and the Diocese of Pittsburgh, thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by myself while participating in the above described event. Furthermore, I hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein.
Further, authorization and permission is hereby given to Resurrection Parish to furnish any necessary transportation, food and lodging for me.
I further hereby agree to hold harmless and indemnify Resurrection Parish, and its employees and agents, for any liability sustained as the result of the negligent, willful or intentional acts of myself, including expenses incurred attendant there to.

I Agree Please select this field.

Health Insurance Company REQUIRED Please fill out this field. Please enter valid data.

Policy Number REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter valid data.

Any known allergies?

Any physical limitations or work restrictions?

Any medically prescribed dietary needs?

I hereby declare these statements to be true and factual. I assume responsibility for my answers and understand all material herein.

Signature REQUIRED Please fill out this field. Please enter valid data.

Today's Date REQUIRED Please fill out this field. Please enter a date.

Trip Deposit50.0