Grace Christian Journey (Emmaus) Application

Is this application for the Christian Adult Journey or Christian Youth Journey? *

Youth Journey is for ages 16-college age
Adult Journey is for 18 and older

Adult Journey

Youth Journey

If you selected Youth Journey - please provide applicants age during the walk

Must be between 16-college age during their walk

Youth Journey applicants birthday

Current Year in School:

High School Sophmore

High School Junior

High School Senior

College Freshman or Sophmore

College Junior or Senior

Does not attend school

Address *

Phone Number *

Name for Name Tag

(If different from above)

Gender *

What church do you currently attend *

T-Shirt Size *

Special Needs*

Do you have any special dietary needs? If so, please explain:

Ex: Diabetic, Gluten-Free, Peanut Allergy, etc.

Do you require any special sleeping arrangements? If so, please explain:

Ex: Top bunk only, Bottom Bunk only, CPAP machine, etc.

Who referred you to the Emmaus Retreat? *

Please provide a name to who told you about the retreat and suggested you go

Sponsor Information*

If you know who your sponsor is, fill out this section. If not, leave it blank and we will match you with a sponsor.

Sponsor's Name

Sponsor's Email Address

Sponsor's Phone

Sponsor's Walk & Location

Ex: Grace #10, E-town YAC #3

Office Use Only**

*If sponsor information is unknown to the applicant, be sure to fill that section out before sending it to the Grace committee.
*Please send completed application to Grace Emmaus of Ky - https://docs.google.com/forms/d/e/1FAIpQLSc2hl7Io5rCbSQ55iNAG8TNwufBw2PqEURh5n7dYqG9M8T9kw/viewform?fbclid=IwAR3EPkWyW1Ay5P_FITeIfQ0RKnLZ-KHQLflTsd7rZvB4du6ZyHU-sgr3BCU&pli=1
*Emmaus registrar director: rissa.mitchell@gmail.com or text to 865-300-4882