CAMPBELLSVILLE CHRYSALIS SPONSOR APPLICATION Candidate’s Name (Just In Case Pages Get Separated): Please Fill All Blanks Of Application (With 'N/A" If Necessary) (Please provide all information requested or it could delay your acceptance.) Sponsor's Information: First name* Last name* Phone* Email* Multi-line address Country/Region* Address* City* Zip / Postal code* Where You Attend Church? Pastor Are You In A Reunion Group?* Yes No If so, what's the name of your group? Type "N/A" if it doesn't apply How Many Candidates Have You Sponsored In The Last Months? How Long Have You Known The Candidate? Are You Praying And Sacrificing For Your Candidate? Why Do You Feel That This Person Would Be A Good Candidate? The Candidate (is/is not) Physically Able To Participate In An Emmaus Weekend.* Is Is Not The Candidate (is/is not) Under Any Temporary Emotional Strain That Might Indicate His/Her Weekend Should Be Postponed.* Is Is Not I Know This Applicant (is/is not) An Active Member Of Their Local Church* Is Is Not Name Of Applicant's Of Their Local Church Will You Assist The Candidate To Get Into A Reunion Group?* Yes No Will You Bring Your Candidate To The Walk On Time (6:30 p.m. Thursday)?* Yes No Will You Attend: Sponsor's Hour?* Yes No Will You Attend: Saturday Night Candlelight?* Yes No Will You Attend: Closing Ceremony?* Yes No Can You Care For The Needs Of Your Candidate's Family Over The Weekend?* Yes No Are You Aware Of The Importance Of Minimal Contact With Your Candidate During The Weekend, Especially If The Candidate Is Your Wife/Husband? Yes No PILGRAM FEE It Is The Board's Desire That Each Pilgrim, Sponsor or Home Church Pay The Pilgrim's Fee. Payments Toward The Cost Can Be Made Prior To Walk Time. The Entire Amount Of Fee Is To Be Paid Upon Registration For Pilgrim To Attend Walk. Be Sure Your Pilgrim T-shirt Size Is Listed On Their Application. $100.00 TOTAL MUST BE PAID AT REGISTRATION TO ATTEND EMMAUS WALK. Parent Signature (For Sponsors under 18) By signing below, you acknowledge that you are the legal guardian of the candidate and that you grant permission for the candidate to attend the specified event. Your signature confirm your consent and understanding of this authorization. Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload. SPONSOR RESPONSIBILITY WITH REGISTRAR DO NOT RETURN THE FOLLOWING PAGES WITH APPLICANTS. THE FOLLOWING ARE FOR EDUCATIONAL AND CHECK OFF LIST FOR THE SPONSORS: The following documents will be available once the application is submitted: Sponsor Responsibility With Registrar Some Question For Prospective Sponsors Sponsor's Checklist Sample Letter Requesting Agape Letters For Pilgrims Supply List For Pilgrims Submit

Girls' Chrysalis Boys' Chrysalis Click on Flight # for a Picture Flight #2 Lisa Wilkerson, Lay Director April 6-8, 2001 Flight #4 Tina Walters, Lay Director October 26-28, 2001 Flight #6 Debbie Benningfield, Lay Director May 3-5, 2002 Flight #8 Susie Wilson, Lay Director October 18-20, 2002 Flight #10 Natalie McVay April 11-13, 2003 Flight #12 Monica Hall, Lay Director October 10-12, 2003 Flight #14 Kellie Bland, Lay Director March 26-28, 2004 Flight #16 Debbie Nunery, Lay Director February 18-20, 2006 Flight #17 Helen Benningfield, Lay Director February 17-19, 2007 Flight #18 Lana Bay, Lay Director February 16-18, 2008 Flight #19 Dana Rafferty, Lay Director February 14-16, 2009 Flight #21 Jan Perry, Lay Director February 13-15, 2010 Flight #22 Bethany Shively, Lay Director January 15-17, 2011 Flight #24 Holly Wilson, Lay Director January 14-16, 2012 Flight #26 Robyn Netherland, Lay Director January 19-21, 2013 Flight #28 Courtney Wooldridge, Lay Director January 18-20, 2014 Flight #30 Lorie Richerson, Lay Director January 17-19, 2015 Flight #32 Paige Cook, Lay Director October 31-November 2, 2015 Flight #34 Kristin Sexton, Lay Director January 14-16, 2017 Flight #36 Jessica Baker, Lay Director February 1-4, 2018 Flight #38 Jill Shipp, Lay Director March 7-10, 2019 Flight #40 Elisha Rhodes, Lay Director March 12-15, 2020 Flight #42 Shajuana Ditto, Lay Director March 11-14, 2021 Flight #43 Sissy Corbin, Lay Director March 3-6, 2022 Flight #45 Deborah Andrejco, Lay Director February 15-18, 2024 Flight #47 Aimee Walker, Lay Director February 27-March 2, 2025 Flight #1 Tommy Corbin, Lay Director March 30-April 1, 2001 Flight #3 Marty Shields, Lay Director October 19-21, 2001 Flight #5 John Benningfield, Lay Director April 19-21, 2002 Flight #7 Greg Rice, Lay Director October 5-7, 2002 Flight #9 David Nunery, Lay Director March 29-31, 2003 Flight #11 Gary Jones, Lay Director October 4-6, 2003 Flight #16 David Nunery, Lay Director February 18-20, 2006 Flight #17 Jim Benningfield, Lay Director February 17-19, 2007 Flight #18 David Harris, Lay Director February 16-18, 2008 Flight #19 C.G. Collins, Lay Director February 14-16, 2009 Flight #20 Chad Shively, Lay Director January 16-18, 2010 Flight #23 Jr. Higdon, Lay Director February 19-21, 2011 Flight #25 Jim Ward, Lay Director February 18-20, 2012 Flight #27 Benson Sexton, Lay Director February 16-18, 2013 Flight #29 Ben Netherland, Lay Director February 15-17, 2014 Flight #31 Mike Richerson, Lay Director February 14-16, 2015 Flight #33 Ben Netherland, Lay Director October 31-November 2, 2015 Flight #35 James Shipp, Lay Director February 18-20, 2017 Flight #37 Michael Humphress, Lay Director February 17-19, 2018 Flight #39 Donnie Munford, Lay Director March 21-24, 2019 Flight #41 Bryan Hafley, Lay Director March 25-28, 2021 Flight #44 David McMahan, Lay Director March 24-27, 2022 Flight #46 Donnie Munford, Lay Director February 29-March 3, 2024 Flight #48 Drew Hayes, Lay Director March 6-9, 2025

CAMPBELLSVILLE CHRYSALIS CANDIDATE APPLICATION Please Fill All Blanks Of Application (With 'N/A" If Necessary) (Please provide all information requested or it could delay your acceptance.) Candidate's Name* Full Name (As You WIsh It To Appear On Your Name Tag)* Phone* Email* Gender* Male Female Multi-line address Country/Region* Address* City* Zip / Postal code* T-Shirt Size S M L XL 2XL 3XL 4XL 5XL Email (MUST HAVE- THIS IS HOW YOU WILL BE INVITED):* Parent's Name:* School:* Grade:* Do You Have Medically Necessary Dietary Needs That The Kitchen Needs To Plan For? * Yes No ***We Do Not Provide Diet Menus Such As Low Fat, Low Carb etc.*** Unless It Is Medically Necessary. If Yes, Why?* Do You Have Heath Problems, Allergies Or Physical Handicaps That May Affect Your Attendance At The At The Walk To Emmaus? Yes No If Yes To Question Above, What?* Are You On Special Medication That The Walk Leaders Need To Monitor For You? Yes No If Yes To the Question Above, What? And When?* Name & Denomination Of Church Attending* Pastor's Name* In What Religious or Community Organizations Are You Active?* What Extracurricular Activities Are You Involved In? I Intend To Be Present For The Entire Walk To Emmaus (THU 6:30pm - SUN 4:40pm)* Yes No Candidate's Signature Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload. Next

CAMPBELLSVILLE EMMAUS Clergy Sheet (CHECK ANY THAT YOU ARE WILLING TO WORK) Click Here Emmaus YAC Chrysalis REC Name* Date picker* Multi-line address Country/Region* Address* City* Zip / Postal code* Phone* Email* Gender* Male Female Are You Currently In A Pastoring Position? (Ex: Lead, Associate, Youth, Assistant, Children) If so, fill in here:* Church You Currently Serve/Attend:* City/State of Church:* Person In Leadership Who we Are Able To Contact:* Phone Number:* Date Of Ordination/License:* Performed By:* Upon Request, Can You Provide A Copy Of The Ordination Certificate?:* Yes No Date Of Clergy Training:* Trained By:* Place Number of Flights/Walks You Have Attended:* Are You Currently Active In A Reunion Group?* Yes No Name Of Reunion Group, Place, and Time: Please Mark Any Area You Are Willing To Serve: Spiritual Director Assistant Spiritual Director Agape Team Kitchen Team Dining Room Team Prayer Team Music Team Board Rep (If on Board) Special Music Logistics Coordinator Mark Talks You Have Given: Prevenient Grace Justifying Grace Means Of Grace Sanctifying Grace Obstacles Of Grace God Designs You God Loves You God's Gift To You God Sustains You God Empowers You Other Please Mark Areas Have Served On An Emmaus/Chrysalis Team: Lay Director/Assistant Spiritual Director/Assistant Table Leader/Assitant Agape Team Kitchen/Dining Room Team Prayer Team Music Team Next

CAMPBELLSVILLE EMMAUS CANDIDATE APPLICATION (Please Fill All Blanks Of Application (With 'N/A" If Necessary) (Please provide all information requested or it could delay your acceptance. Spouses must complete a separate application.) I Intend To Be Present For The Entire Walk To Emmaus (THU 6:30pm - SUN 4:40pm)* Yes No Candidate's Name* Full Name (As You WIsh It To Appear On Your Name Tag)* Phone* Email* Multi-line address Country/Region* Address* City* Zip / Postal code* Select Highest Education Level* Do You Have Medically Necessary Dietary Needs That The Kitchen Needs To Plan For? * Yes No ***We Do Not Provide Diet Menus Such As Low Fat, Low Carb etc.*** Unless It Is Medically Necessary. If Yes, Why?* Do You Have Heath Problems, Allergies Or Physical Handicaps That May Affect Your Attendance At The At The Walk To Emmaus? Yes No If Yes To Question Above, What?* Are You On Special Medication That The Walk Leaders Need To Monitor For You? Yes No If Yes To the Question Above, What? And When?* Name & Denomination Of Church Attending* Pastor's Name* In What Religious or Community Organizations Are You Active?* Have The Following Been Explained To You or Spouse? "Select Yes/No To The Following" Walk To Emmaus?* Yes No Follow-Up Group Reunion/Accountability?* Yes No Is Your Spouse Committed To Attending An Emmaus Weekend?* Yes No Possibly Later Has Been Already Candidate's Signature Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload. Sponsor Name & Phone # (Where Sponsor Can Be Reached During Walk) Next