Golden Opportunities Wisconsin Pilgrimage Registration - Single Occupancy
October 2-4, 2024
This form should be filled out for only
one attendee
.
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
*
E-mail
*
example@example.com
Please list any food allergies (if none, please write N/A):
*
Emergency Contact:
*
First Name
Last Name
Emergency Contact Phone Number:
*
Please enter a valid phone number.
Emergency Contact Email:
*
example@example.com
Do you have any medical issues that you'd like to note:
I acknowledge that due to reservation and cancellation policies contracted in advance with travel sites and hotels, there will be no refunds issued after August 30th.
Yes - I agree
RELEASE OF LIABILITY: I agree on behalf of myself, my heirs, assigns, executors, and personal representatives, to hold harmless and defend Our Lady of Grace, its officers, Archdiocese of St. Paul and Minneapolis it's directors, agents, employees, or representatives associated with this offsite event from any and all liability claims, loss or damage arising from or in connection with my participation in the offsite event.
*
Yes - I agree.
Submit
Should be Empty: