Online Application

Step 1 of 4 - Applicant Information

Below you will find the Online Application for Chrysalis weekends, called Flights, in the Son Coast Chrysalis Community. This method is provided as a convenience and does not guarantee you a reservation on a weekend until confirmed by the community Registrar.

Applicants for the Chrysalis Flight must first have a sponsor. This can be any youth or adult who has attended an Emmaus-type retreat through the Presbyterian, Episcopal or Catholic Church, including youth from a Chrysalis, Journey, and Kayak, and any adults who have attended Emmaus, Kairos, Kairos Outside, and Cursillo (Presented by the Catholic church and the original model for Emmaus). Once a person has attended any one of these weekend retreats, that person may sponsor an appropriate candidate for any of these weekends.

This Online Application includes two parts, one for the attendee, called a caterpillar, and one for the sponsor. Both sections much be filled out completely. At the end of the Online Application, there will be a choice to either mail your payment (Deposit or full amount), or to pay via PayPal. Either method can be used but the application will not logged in until the application has been reviewed by both the Community Registrar and the Community Treasurer.
Name*
First Last
Name for Nametag
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Age*
Gender*
- Male
- Female
T-Shirt Size*
Address*
Street Address Mailing Address City State ZIP Code
Home Phone
Cell Phone
Applicant's Email*
School*
Grade*
Church*
Pastor/Youth Pastor*
Has Chrysalis and follow-up been explained to you?*
Any medications, allergies, special diet?*
Please explain your medication, allergies, or special diet requirements

Parents Section
Parent's Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Relationship*
Primary Phone*
Parent's Email*
Have you attending an Emmaus Walk?
Community Name
Walk Number
Any medical problems or other pertinent information*
Medical Insurance Company*
Insurance Policy Number:*
Since this is an electronic form, the parent listed above, will need to download a Parental Permission Form, and mail to the registrar before the application is confirmed as completed.
As an applicant, by clicking next you certify that all information has been entered correctly and you agree with the following statement:
- I understand that if I am unable to attend the Flight for any reason, my deposit (currently $50) will roll over along with my application to the next available date.
- I understand that the cost for the Chrysalis Weekend is not guaranteed beyond the current year.
- I understand that the total cost for the Chrysalis Weekend is currently $150, that also include a free SCC T-Shirt.

Sponsor's Section
Sponsor Name*
First Last
Sponsor's Email*
Primary Phone*
If you are a sponsor from a different community, please include your address and home church so we may add you to our database.
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Church
Pastor
Sponsor's Emmaus/Chrysalis Community*
Sponsor's Original Flight/Walk #*
Are you in a Reunion/NextSteps Group?*
Are you a first time Sponsor?*
Have you reviewed the steps to good sponsorship?*
Since you are a first time sponsor, please download How to Be a Sponsor to assist you. The Registrar will be in touch.
By clicking next below, I understand that by undertaking sponsorship, I agree to meet ALL ‘Special Agape' obligations in regard to my caterpillar. I will agree to attend all services, pray for, and be available to my caterpillar and, as required, as act of sacrificial Agape for this person.

Thank you for completing your application. For your application to be complete and accepted, you will need to process either the application deposit ($50) or the complete fee($150). The cost covers weekend fees and a free T-Shirt for each caterpillar.

We can accept your payment with a credit/debit card, processed via PayPal (including PayPal's processing fee) by click the link below:

Fees

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you can mail your payment via USPS:

Parents remember to download a Parental Permission Form to confirm this online application.

Online Application

Step 1 of 4 - Applicant Information

Parents Section

Sponsor's Section

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