St. Rose of Lima

A Catholic Church located in Gaithersburg, MD

All Are Welcome • Todos Somos Bienvenidos

Pray ... Grow ... Serve
Orar ... Crecer ... Servir

Flocknote

Hershey Park Trip 2020

- Faith Formation

Join us for a trip to Hershey Park
late-Summer 2020!

Note: Permission slips & payment have a hard deadline of TBD to the Parish Offices. We are getting discounted tickets and need to reserve each ticket by name of participant. Any permission slips turned in after TBD may have to pay the full $65 entrance fee. Turn your permission slip in early!

What?	Hershey Park Day Trip (bring a modest bathing suit & towel with you in a small bag)
When?	Date TBD 6:30 AM – 8:30 PM
Where?	Meet at St. Rose of Lima at 6:30 AM (eat breakfast beforehand or bring it with you!)
Cost?*	$TBD for discounted entrance ticket (cash or check to St. Rose of Lima) Please bring ~$25-30 cash for meals (lunch at the park, snacks/souvenirs, dinner at Cracker Barrel on the way home) *Financial assistance available, please reach out to Molly

Instructions to Register

1. Fill out the registration form below by TBD

2. Download the Parent & Youth Activitity Permission Form, print & sign it (both parent and youth must sign).

3. Turn in the Parent & Youth Activity Permission Form & $45 in cash or check ("St. Rose of Lima") to the Parish Office by Tuesday, August 7th
The maximum number of form submissions has been reached. This form is currently not available.
- Participant 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 (for Flocknote updates) REQUIRED Please fill out this field. Please enter an email address.
- Cell Phone Number (for day of communication at the park) REQUIRED Please fill out this field. Please enter a phone number.
- Participant Medical Info
- Allergies REQUIRED Please fill out this field. Please enter valid data.
- Medications REQUIRED Please fill out this field. Please enter valid data.
- Other health concerns REQUIRED Please fill out this field.
- Insurance Company Name REQUIRED Please fill out this field. Please enter valid data.
- Insurance Policy Plan Number REQUIRED Please fill out this field. Please enter valid data.
- Insurance Company Phone # REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Information
- Emergency Contact #1 (Parent/Guardian)
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Relation to Participant REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Other Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Emergency Contact #2 (Parent/Guardian preferred, may be neighbor/family/friend)
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Relation to Participant REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Other Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Please fill out the name & email of the person completing this form to receive a confirmation email of your registration.
- 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.
Submit

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Contact Us
- Sheila Shea
  
  Acting Coordinator of Youth Ministry & Young Adult Faith Formation
  
  240-454-5287 or 301-948-7545 X225
  SSheaStRose.com
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St. Rose of Lima

A Catholic Church located in Gaithersburg, MD

All Are Welcome • Todos Somos Bienvenidos

Hershey Park Trip 2020

Join us for a trip to Hershey Park
late-Summer 2020!

Instructions to Register

1. Fill out the registration form below by TBD

2. Download the Parent & Youth Activitity Permission Form, print & sign it (both parent and youth must sign).

3. Turn in the Parent & Youth Activity Permission Form & $45 in cash or check ("St. Rose of Lima") to the Parish Office by Tuesday, August 7th

Participant Information

Participant Medical Info

Emergency Contact Information

Please fill out the name & email of the person completing this form to receive a confirmation email of your registration.

Contact Us

Hershey Park Trip 2020

Join us for a trip to Hershey Park late-Summer 2020!

Instructions to Register

1. Fill out the registration form below by TBD

2. Download the Parent & Youth Activitity Permission Form, print & sign it (both parent and youth must sign).

3. Turn in the Parent & Youth Activity Permission Form & $45 in cash or check ("St. Rose of Lima") to the Parish Office by Tuesday, August 7th

Participant Information

Participant Medical Info

Emergency Contact Information

Please fill out the name & email of the person completing this form to receive a confirmation email of your registration.

Join us for a trip to Hershey Park
late-Summer 2020!