Mission Trip 2026 - Harlingen, TX (Early Bird)

July 5-11, 2026 | Please fill out this form and click submit.

For more information on Adventure in Missions please visit: https://adventures.org/trips/destinations/south-texas/
Grant Ripperger will be sending out updates through the parent email that is provided on this form.

*Jan 25-Mar 29 – Early Bird Registration $350 ($100 deposit)*

*Mar 30-Apr5 – Registration $450 ($175 deposit)*
*Apr 5-May5- Late Registration $500 (Paid in full)*

*May 5 - Registration Deadline*

*June 24 - Leader meeting @ Westland Youth Garage 7:30 - 8:00 pm*

*June 28 - Mandatory Parent Meeting @ Westland Chapel 12:30PM-1:00 pm*

Student Name

Parent Email

This address will receive a confirmation email

Address

Parent Phone

Student Date of Birth

Shirt Size

Please select one option.

S M L XL XXL

Grade Completing

Please select one option.

12th 11th 10th 9th 8th 7th 6th

Name of School

Emergency Contact

Emergency Contact Number

Allergies

Medications you are currently taking:* Regarding medication, every person bringing medication to camp will need to include a signed Medication Form in a Ziploc bag with their medications. **Forms will be available at the parent meeting, June 28.

Name of Insurance

Insurance Phone Number

Policy/Group/ID Number

Payment

Deposit (Early Bird) (100) Early Bird Price (350) Sponsor ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

July 5-11, 2026

Please fill out this form and click submit.

For more information on Adventure in Missions please visit: https://adventures.org/trips/destinations/south-texas/
Grant Ripperger will be sending out updates through the parent email that is provided on this form.

Mission Trip 2026 - Harlingen, TX (Early Bird)

Description

Please Fix the Following