Chrysalis Flight Reservation (Parent)
This portion of the Application should be completed by the PARENT AND/OR LEGAL GUARDIAN.
  • If you are looking for the Sponsor Application, please copy the following into your address bar:
  • Disclaimer/Medical Waiver

    I/WE hereby give MY/OUR permission and written consent for MY/OUR child to attend the Chrysalis Weekend. I/WE give permission for the Chrysalis staff to seek medical treatment for MY/OUR child if necessary.

    If you agree with this Disclaimer/Waiver please indicate by typing your name below. This will serve as a binding signature.

    We realize that anyone could potentially sign in their parent's/legal guardian's stead, and because of this we require a parent/legal guardian phone number and email address.
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  • NOTE to Parent/Guardian:

    Please inform the candidate sponsor for the weekend that they need to access our website and fill out the sponsor portion of the application. This is EXTREMELY IMPORTANT that we receive their portion in a timely manner.

    If your child does not currently have a sponsor and you do not know someone from the Emmaus/Chrysalis community to sponsor them, please send us an email at explaining your situation and we will help find a sponsor.
  • This concludes the PARENT portion of the application. If you are a parent AND sponsor of a candidate, please proceed to fill out the SPONSOR portion of the application after clicking Submit.

    Otherwise, please close the page after you click Submit.