Pilgrim Application
The Walk to Emmaus is a short course in Christianity. It is meant to strengthen those who are already disciples and active church members of a Christian congregation.
Name
*
Preferred name for name tag
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Occupation
*
If you're married, has your spouse attended a Walk to Emmaus? If so, when and where?
Name and denomination of your church
*
Pastors Name
*
Are you active in this church?
*
Yes
No
If yes how are you involved?
HEALTH INFORMATION
Do you have any special needs, such as a medically required diet, food allergies, medical problems, etc.?
*
Yes
No
Do you have any physical impairments, such as hearing loss, vision loss, difficulty walking or climbing stairs?
*
Yes
No
Please explain if yes to either of the above
Do you smoke/vape? (This information is needed for roommate placement)
*
Yes
No
Please list any special needs
Contact person other than spouse
*
Their Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Their Phone Number
*
Format: (000) 000-0000.
PREPARATION AND COSTS
You must be sponsored by someone who has completed a Walk to Emmaus, Cursillo, Tres Dias or similar 3-day weekend. Has the Walk to Emmaus been fully explained to you?
*
Yes
No
Briefly explain why you want to attend the Walk to Emmaus and what you expect from the Walk:
*
A registration deposit is required in order to hold your place. We accept electronic payments via Venmo and CashApp, or someone can contact you to make arrangements to pay in another way. Please indicate which method you prefer.
*
I wish to pay electronically
I wish to pay by another method.
Electronic signature acknowledging the following: The Walk to Emmaus weekend begins on Thursday evening at 6 PM and ends on Sunday evening. Because our world is full of distractions your electronic devices (including but not limited to cell phones, watches, laptops and tablets) should be left at home during the weekend. Your sponsor will act as a point of contact in the event of an emergency.
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: