Lake Cumberland Area Emmaus & Chrysalis Community
EMMAUS Registrar
​Kayla Glover
​775 Mount Moriah Rd
Summer Shade KY 42166
Emmaus  Pilgrim Application(Click Here) Printable form

Emmaus- Medical Form 

​​Application can be printed, filled out and mailed to the registrars OR you can save it to your desk top
​and email it to All Chrysalis apps should be submitted on line or mailed to Camryn Coots.
​Deposit/payment (check) can be mailed with your applications or you can pay deposit/fee by using PayPal . 
​                                     Thank you  


​Chrysalis Caterpillar Application (printable version) ​Click Here

Chrysalis-Medical Form
Covid-19 Waiver
Applications you can use the on-line form, or you may print and fill out the app and mail it in to the Chrysalis Registrar. Prefer email or have a question? You can email 
A $30.00 deposit is required to hold caterpillar/ pilgrim spot.

Emmaus/Chrysalis Registration Fee $30.00 click the DONATE  below to use Pay Pal. You can pay with a credit card, debit card or by a Pay Pal account. 
                           Emmaus Worker Application/ Chrysalis Worker Application                               
Can be found under the Team Selection Tab.​

                                         Click Here

ALL Emmaus workers must be 18 years of age and older. No back ground check required to work Emmaus walks. ​Any adult working Chrysalis Flight must have a back ground check completed.
Note: Workers and Pilgrims/Caterpillars need a Medical form filled out.
Need help knowing how to ask for those 12 Agape Love letters for your Pilgrim/Caterpillar? Try using this form. Just click here.

If paying fees for a pilgrim or a caterpillar please make sure to list this person name in the purchase details.
Camryn Coots
64 Selby Hopper Rd​
Russell Springs KY
Chrysalis Application On-line form
Click Here​

We welcome our new 
​ Emmaus Registrar
​Kayla Glover and
​ Chrysalis Registrar Camryn Coots​!