C3 Juarez Mission Trip - June 14-17, 2026

June 14-17, 2026 | Please fill out this form and click submit.

Name (as it appears on your passport)

*

Email

*

This address will receive a confirmation email

Phone

*

Gender

*

Please select one option.

Male Female

T-Shirt Size

*

Please select one option.

X-Small Small Medium Large XL XXL

Date of Birth

*

Southwest Rapid Rewards Number (if you have one)

Select Your Payment

Pay Deposit Now ($100) Pay Half Now ($350) Pay in Full Now ($700)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

June 14-17, 2026

Please fill out this form and click submit.

Close