Diocese of Sioux City

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

PARISH GROUP REGISTRATION

Thank you for registering a parish group for Miracle Church Bus, letting good things run wild. We look forward to seeing you on Thursday, June 12th in Carroll County Visit www.scdiocese.org for more information.

Registration

Qty

Description

Amount

Total

Total seats(s) - Willey pick-up
40 remaining

$20.00

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This location will pick up and drop off at St. Mary's Catholic Church in Willey IA. This includes both students and chaperones.

Total seats(s) - Breda pick-up
40 remaining

$20.00

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This location will pick up and drop off at Good Shepherd church in Breda. This includes both students and chaperones.

Total: $0.00

Student & Adult Registrant Information

Total number of Students:

Adult Chaperones:

Please indicate number of adults chaperones registered above. Note: 1 adult for every 10 students is required.

Group Leader Information

Group Leader Name: *

(leader attending the event)

Phone Number:

Email:

I have read:

You, as the group leader, are responsible for collecting the necessary information from each participant attending, youth and adult. The parish group leader spreadsheet must be turned in by June 1st, 2025 by email to daniellef@scdiocese.org

Parish Leader Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *