Online Application

Did you know that you can register an applicant online? Try our new online form and we will be in touch soon. Thank you in advance for your willingness to serve. On this page, you will find the Online Application for the Walk to Emmaus in the Coastal Carolina Emmaus Community. This method is provided as a convenience, but you still can download the tradition application and mail to us.

Step 1 of 6 - Applicant Information

Below you will find the Online Application for the Walk to Emmaus in the Coastal Carolina Emmaus 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 Emmaus Walk 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 pilgrim, 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
Gender*
- Male
- Female
Date of Birth*
Date Format: MM slash DD slash YYYY
Name for Nametag
First Last
Address*
Street Address Mailing Address City State ZIP Code
Home Phone
Work Phone
Cell Phone
Email*

Please list any significant Health conditions we should be aware of in an emergency, even if they are currently well managed.*
Do you have any physical limitations we should be aware of? If so, please describe so we can accomodate your needs (i.e. do you use a walker or wheelchair, have difficulty climbing stairs, having hearing or vision problems, need a handicap assessible shower, etc.)*
Do you take medications during the day, other than at rising in the morning, with meals, or bedtime? If so, provide a list of medications and a time that you need to take them:*
Please list any NESESSARY food allergies or dietary requirements (Latose intolerance, vegetarian, peanut allergies, etc):*
Emergency Information (other than Spouse)
Emergency Contact*
Relationship*
Primary Phone
Email

Pastor's Name
Prefix First Last
Church Name*
Church Phone
Alternative Phone

Has the purpose of the Walk been explained to you?*
Has your sponsor discussed follow-up activities?*
Can you attend on short notice?*
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 Walk 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 Walk to Emmaus is not guaranteed beyond the current year.
- I understand that the total cost for the Walk to Emmaus is currently $150.

Sponsor Name*
First Last
Email*
Primary Phone*
Alternative Phone
Do you feel your Pilgrim is able to climb stairs?*
Do you feel your Pilgrim is able to sleep on a top bunk?*
The Salt and Light Center has both regular stairs and low impact stairs, as well as ramps for guests. Wheelchairs are available on site.
Is there anything you feel the team or the Spiritual Directors should know about your Pilgrim (Recent significant illness, injury, bereavement ot trauma)?
Sponsor's Original Walk #*
Sponsor's Walk Community*
Sponsor's Reunion 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 and Sponsor Mentor will be in touch.
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
By clicking next below, I understand that by undertaking sponsorship, I agree to meet ALL ‘Special Agape' obligations in regard to my pilgrim. I will attend all three of the weekend services, pray for my pilgrim continuously, and be available to my pilgrim's family over the weekend if needed, as an act of sacrificial Agape for my pilgrim. After the Walk, I will assist my pilgrim in attending the follow-up meeting and helping him or her find a reunion group.

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).

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

Emmaus Fees

you can mail your payment via USPs:
P.O. Box 4826
Wilmington, NC 28406

Step 1 of 6 - Applicant Information

Emergency Information (other than Spouse)

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Step 1 of 6 - Applicant Information

Emergency Information (other than Spouse)

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