Walking Pilgrimage Permission Form

Walking Pilgrimage Registration
Event Information

Class/Grade Level : High School

Event Description :  A walking pilgrimage from St. Charles to the Cathedral of the Immaculate Conception, 1105 Calhoun St, Fort Wayne, IN 46802. Participants will have the opportunity to participate in the special Jubilee year and gain a plenary indulgence.

Purpose of Event : Spiritual Formation

Date / Approx. Time of Check-In :  Wednesday, July 30 at 8:15am at the St. Charles Youth Center, 4904 Trier Rd, Fort Wayne, IN 46815

Date / Approx. Time of Departure : Wednesday, July 30 at approx. 12:30pm at the Cathedral of the Immaculate Conception (see address above)

Transportation : Students will walk on foot from St. Charles to the Cathedral. Parents/guardians/families are invited to meet us for the 12:05pm Mass for pick-up. Transportation via chaperones cars or a mini bus/school bus back to St. Charles may be provided if necessary for students whose parents cannot make to the the Cathedral (see question below).

Cost :  Free

Other Notes : Please be sure to wear good walking shoes and bring a water bottle and Rosary if you have one. We will stop at Lakeside park on the way for restrooms and snacks.

Stacey Huneck and Anna Laisure are in charge of this event. Stacey's emergency contact info is (260)207-4677.
Are you registering a youth participant or as an adult youth ministry leader?

Youth ParticipantAdult Chaperone

Adult Chaperone Registration

(We will be in touch with a waiver for you to sign, we just don't have it electronically formatted yet. Thanks for your patience!)
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Due to the nature of this event, we are requiring our chaperones to sign an emergency medical care form. For your convenience, we have embedded it here. However, this is technically a separate form which is why you have to type your name and email again. It has a GREEN "Submit" button.

After clicking the GREEN "Submit" button, please be sure to scroll to the bottom of this page and click the BLUE "Next" button.

THERE IS ANOTHER PAGE AFTER THIS! Your registration is not complete yet, so do not close out of this tab!
Please check before moving on.*

I am verifying that I have signed and submitted the above Annual Emergency Medical Care Form.

Parent/Guardian Permission and Release
Youth Participant Name*

First NameLast Name
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.
Will your child need transportation back to St. Charles after the 12:05pm Mass at the Cathedral?*

YesNo
I have completed a St. Charles Annual Emergency Medical Care Form for my child in the 2025-2026 academic year or since July 1, 2025.*

YesNoUncertain
The 2025-2026 Annual Emergency Medical Care Form can be filled out at www.stcharlesfortwayne.org/welcome-packet. (This link will also be available on the confirmation page.)

*A new Event Participation form must be completed for each Event. Information provided in the Annual Emergency Medical Care Form will apply to each Event in which your child is allowed to participate during the Youth Ministry Program year. Parents/guardians are responsible for updating the information on that form should changes occur during the Youth Ministry Program year.
I allow my child to participate in the parish event trip to the Cathedral of the Immaculate Conception on Wednesday, July 30 from 9:00am-12:45pm.

In consideration of the aforementioned participant, my child, being allowed to participate in this event, I, on behalf of myself, my child and my child’s other parent/guardian, hereby acknowledge recognition that such an activity may expose my child to risks and hazard not ordinarily encountered in the parish youth ministry program. Further, on behalf of myself, my child, and my child’s other parent/guardian, I hereby release and agree to hold harmless the above named parish and the Diocese of Fort Wayne-South Bend, Inc. to the fullest extent permitted by law from any and all claims, judgments and liability of every kind for any injury and damage of any kind, whether personal or property, that we or any one of us may suffer or incur due to my child’s participation in the event, regardless of whether the injury or damage is attributable to the fault of parties other than the Parish or Diocese or attributable to the fault, including negligence, of the Parish or Diocese.

I have instructed my child to follow the rules of conduct as directed by the parish youth ministry program and Diocese.

Thank you for registering for this event! Please provide a signature below to finalize your registration. If you have questions abour your registration or about the event, please contact Stacey Huneck at youthministrystcharles@gmail.com.
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Walking Pilgrimage Registration

Adult Chaperone Registration

Parent/Guardian Permission and Release