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*
Indicates required field
Please register by Wednesday, October 11, 2017.
The cost is _____, which includes transportation to Guelph and back, as well as dinner. Cheques should be made payable to St. Michael's parish.
Payment must be collected before you board the bus. If you are arriving independently, pay ____ upon arrival at the Basilica.
INFORMED CONSENT
By submitting this form, you acknowledge the following:
ELEMENTS OF RISK:
By choosing to participate in the Fall Pilgrimage on October 18, 2017, you are accepting the responsibility for any injury that might occur. You agree to follow all the directives of the pilgrimage supervisors. You agree that no alcohol, illegal drugs, drugs not prescribed for you, or weapons of any kind are to be brought on the pilgrimage. The Diocese of Hamilton will not provide accidental death, disability, dismemberment or medical expense insurance on behalf of the participants in this activity.
Acknowledgement
*
I certify that I am 18 years of age or older and I have read, understood, and agreed to the conditions above. I understand that, by participating in the activity described above, I am assuming the risks associated with doing so.
Name
*
First
Last
Street Address in Waterloo
*
Address line 2
*
Postal Code
*
Phone Number
*
Email
*
School
*
Wilfrid Laurier University
University of Waterloo
Conestoga College
Other
Emergency Contact
*
Emergency contact phone number
*
Known dietary restrictions, drug allergies, or health conditions you want us to know about
*
If you have food allergies that we can accommodate, we will do so unless we contact you in advance to advise you otherwise. Any drug allergies or health conditions you disclose will be disclosed to medical personnel caring for you in the event that you should require medical care while with us.
Submit
Home
About Us
Our Mission
Faith Groups
Meet Father Jamroz
Weekly Events
Sunday Mass
Tuesday Adoration
Morning Mass and Lauds
Family Dinner and Forge
Bible Intake
Calendar
Hours of Operation
Contact