412 Mission

Congratulations on your decision to participate in our mission trip to Appalachia, West Virginia from June 15-21, 2025! Your experience will be on that you will never forget.

In Appalachia we will provide home repairs, wheelchair ramp repair, painting, cleaning, and general fixup for elderly and low-income communities. You will be the hands and feet of Jesus to people whom you have never met and may never see again. They will remember you for your unselfish act of service.

To register, please fill out all the fields below.

One form per person.

Registration closes March 1, 2025.

The total cost of the trip will be $300. This includes Appalachia registration, transportation, lodging, meals, and fun events. To secure your place on the trip, a $100 non-refundable deposit is due while registering by credit card below or mailing a check. You will not be officially registered until we receive your deposit.

All participants are responsible for an additional $200 fee (for a total of $300), due by March 30, 2025.

Final payments may be made on the website after March 1, 2025 by credit card or check payable to: “OLPH - Appalachia” and write Your Name in memo and on envelope.
Our Lady of Perpetual Help Rectory
Attn: OLPH - Appalchia
2510 Middle Road
Glenshaw, PA 15116

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Select One REQUIRED Please fill out this field.

Participants Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Participants Email REQUIRED Please fill out this field. Please enter an email address.

Address: Street REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Note: If you are turning 18 prior to June 1, 2025 you will need to get your Safe Environment Clearances.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Participants category REQUIRED Please fill out this field.

Home Parish REQUIRED Please fill out this field. Please enter valid data.

School attending (if applicable) Please enter valid data.

Current year (if applicable)

T-shirt Size (Adult Sizes) REQUIRED Please fill out this field.

Parent/Guardian Name #1 REQUIRED Please fill out this field. Please enter valid data.

Parent/Guardian Phone Number #1 REQUIRED Please fill out this field. Please enter a phone number.

Parent/Guardian Email #1 REQUIRED Please fill out this field. Please enter an email address.

Parent/Guardian Name #2 Please enter valid data.

Parent/Guardian Phone Number #2 Please enter a phone number.

Parent/Guardian Email #2 Please enter an email address.

Select all that you are willing and able to do on the Mission Trip. REQUIRED Painting Heavy Lifting Power Tools Landscaping Roof Work Please fill out this field.

Why would you like to participate in the 412mission with Our Lady of Perpetual Help To Appalachia in June? REQUIRED Please fill out this field.

Do you have an allergy to bee stings? REQUIRED Yes No Please fill out this field.

Do you have an allergy to cat dander? REQUIRED Yes No Please fill out this field.

Do you have any other allergies? (Please specify) Please enter valid data.

By clicking below, you are committing to stay the whole week in West Virginia, to attend the Mandatory Pre-Trip Workshop (Time TBD), to volunteer at our St. Patrick's Day Fundraiser (March 9, 2025) and an additional fundraiser. REQUIRED I commit to the above Please fill out this field.

Please check the boxes below. I will hold neither Our Lady of Perpetual Help Parish nor any Staff or Volunteer accompanying this group responsible for any accident/injury to my child. The Staff/Volunteers on this trip have my permission to take my child to the nearest hospital for medical treatment, if necessary, after I am contacted. If my child needs to take medication while participating in this trip, I hereby give my child permission to self-administer his/her medication My teen shall comply with all of the rules set forth by Our Lady of Perpetual Help Parish and 412Missions I give my teen permission to ride with Our Lady of Perpetual Help Parish Staff/Volunteer who is approved to drive through the Diocese of Pittsburgh background check.

I give Our Lady of Perpetual Help Parish permission to use my photo on their website, bulletin, & social media. REQUIRED Yes No Please fill out this field.

Registration Fee100.0

Our Lady of Perpetual help

St. Mary of the Assumption &
St. Ursula Churches

412 Mission

What is it like?

WE ARE HIS HANDS AT WORK.

412Mission Appalachia Registration

June 15 - 21, 2025

Safe Environment