Apply for a Chadash wilderness trip

Prefer paper? Print the application, fill it in by hand, and mail it in with your check.Print a paper application

Contact information

Email *

Name *

Age *

Date of birth *

Street address *

City *

State *

ZIP *

Phone *

Cell phone (if different)

Parent/legal guardian names *

Name of church you presently attend *

Pastor *

Pastor's phone number *

Trusted friend, adult, or mentor — full name *

Someone staff can contact if there are questions or red flags.

Trusted friend, adult, or mentor — phone *

Someone staff can contact if there are questions or red flags.

What would you like to learn/experience on this trip? *

Trusted friend, adult, or mentor — email

Someone staff can contact if there are questions or red flags.

Emergency contact #1 name *

Emergency contact #1 relationship *

Emergency contact #1 phone *

Emergency contact #2 name *

Emergency contact #2 relationship *

Emergency contact #2 phone *

How will you be paying the non-refundable application fee of $250? Additional details will be sent in a follow-up email. *

Check sent through the mail Online through Zeffy

Applicant signature (type your full name) *

Date: 11/13/2026