2026 Annunciation Youth Ministry Mission Trip Registration

2026 Annunciation Youth Ministry Mission Trip Registration

Logan County, West Virginia | July 10–19, 2026
Join Annunciation Youth Ministry as we travel to Logan County, West Virginia for a week of service, prayer, and community through our ongoing partnership with YouthWorks. This form is required for all participants — youth (grades 10, 11, and 12) and adults — joining the 2026 Mission Trip.
Participant Name*

First NameLast Name
Participant Email*
Participant Phone Number
Format: (000) 000-0000.
Gender*
Birthdate*

MonthDayYear
T-Shirt Size*
Current School*
Graduation Year*
Address*

Street Address

Street Address Line 2
CityState / Province Code (e.g. MN, WI)Postal / Zip CodeCountry
Parent or Guardian Name*

First NameLast Name
Parent or Guardian Phone*
Format: 000-000-0000.
Parent or Guardian Email*
Parent or Guardian Name

First NameLast Name
Parent or Guardian Phone
Please enter a valid phone number.Format: 000-000-0000.
Parent or Guardian Email
example@example.com
Health & Medical Information

Please complete all fields accurately. This information is confidential and used only for the care and safety of participants during the mission trip.
Health Insurance Information*
Provide the participant’s current health insurance details. (1) Insurance Company, (2) Policy or Member Number, (3) Policyholder Name, (4) Group Number (if applicable), (5) Insurance Phone Number
Physician Information*
In case of medical need, we may contact the participant’s primary care provider. (1) Physician Name, (2) Clinic or Practice Name, (3) Office Phone Number, (4) City/State
Emergency Contact*
Please list someone other than a parent/guardian who can be reached 24/7 during the trip. (1) Emergency Contact Name, (2) Relationship to Participant, (3) Phone Number(s), (4) Alternate Contact (optional)
Medications & Health Conditions*
Provide details that will help our adult leaders and medical staff offer appropriate care. (1) List any current medications, including dosage and timing. (2) List any allergies (food, medication, or environmental) (3) Note any medical, physical, or mental health conditions we should be aware of. (4) Any dietary restrictions or preferences. Note: All medication (prescription or over-the-counter) for youth participants must be turned in at check-in and managed by our designated adult leader or nurse, per Catholic Mutual safety policy.
Chemical Use / Possession Policy: Annunciation Youth Ministry prohibits the possession, purchase, sale, distribution, or use of mood-altering chemicals, alcohol, or controlled substances during any AYM-sponsored event or while on Annunciation Church grounds or transportation. Any youth found in violation of this policy will be immediately removed from the event, parents will be contacted, and local authorities may be notified as deemed appropriate.*

I have read and agree to abide by the Chemical Use/Possession Policy.
Abuse and Harassment Policy: Annunciation Youth Ministry prohibits any form of sexual harassment, physical abuse, or sexual abuse, whether on or off parish premises or in the course of ministry activities. AYM will seriously investigate all allegations of misconduct in accordance with applicable law. Annunciation Church and the Archdiocese of St. Paul and Minneapolis will not retaliate against any individual who, in good faith, reports such misconduct.*

I have read and understand the Abuse and Harassment Policy.
Clothing Policy: All AYM participants are representatives of the Annunciation faith community. We ask all youth and adults to dress in a way that respects themselves and others. Please do not wear clothing that distracts from the youth group environment, including: tank tops, short shorts, visible undergarments, or apparel with obscene, vulgar, or discriminatory language or images. This also includes clothing that advertises or promotes alcohol, chemicals, tobacco, or any other products illegal for use by minors.*

I have read and agree to follow the Clothing Policy.
Liability & Indemnity Agreement: In consideration of my (or my child’s) participation in this activity, I agree to indemnify and hold harmless Annunciation Church, Annunciation School, and the Archdiocese of St. Paul and Minneapolis from any claims brought against them by myself, my child, or others that arise out of any behavior by my child at or during this event/activity. I also agree to pay reasonable attorney’s fees and expenses incurred by the parish/school/Archdiocese in defense of such a claim or lawsuit.*

I have read and agree to the Liability & Indemnity Agreement.
I grant permission for Annunciation Youth Ministry to use photos or videos of my (or my child’s) participation for ministry purposes.I do NOT grant permission for photos or videos to be used.
Parent/Guardian Electronic Signature: By signing below, I acknowledge that I have read and agree to the policies and permissions stated above. My electronic signature has the same legal effect as a handwritten signature.*

First NameLast Name
Date*

MonthDayYear
Date
Payment Information

The total cost of the 2026 Annunciation Youth Ministry Mission Trip is $1,200 per participant.
This cost includes all transportation, lodging, group meals, program fees, and cultural activities for the week in Logan County, West Virginia.

To reserve your spot, a $400 deposit is due at the time of registration.
Remaining balances and fundraising opportunities will be discussed at the required Mission Trip Meeting on Monday, December 1 at 7PM in the Annunciation School Auditorium.

We never want finances to prevent anyone from attending.
If you need a payment plan or financial assistance, please contact Ellie Mertens (elliemertens@annunciationmsp.org) directly and confidentially before submitting your deposit.
$400.00 Credit/Debit Deposit (a link will be sent to you to pay)Mailing a check made out to AYMFinancial assistance requested
Overall Community Status*
HUB Unique ID
Should be Empty:

2026 Annunciation Youth Ministry Mission Trip Registration

Health & Medical Information