Event Registration Form

Pilgrim Virgin Statue, Divine Mercy & Home Enthronement to the Sacred Heart of Jesus & the Immaculate Heart of Mary - Registration Form

Invite Our Lady and the Divine Mercy of Jesus into your home and entrust your family to the Sacred Heart of Jesus and the Immaculate Heart of Mary. Please complete your personal details and select the devotion(s) you would like to receive, along with your preferred date. **Please note** Pilgrim Virgin Statue: The statue is brought to your home and remains with your family for one week. Visits are arranged for Thursday evenings at 7:00 p.m. Home Enthronement: Enthrone your home to the Sacred Heart of Jesus and the Immaculate Heart of Mary. Enthronements are offered on Thursday evenings at 7:00 p.m. Divine Mercy Image: The image is brought to your home, with dates scheduled flexibly in accordance with the 9-day Divine Mercy Novena.
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Preferred THURSDAY Date for Visit – Pilgrim Virgin Statue & Enthronement. A Legion of Mary member will follow up with you to schedule the Divine Mercy devotion.

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Select the Devotion or Service
Should be Empty:

Pilgrim Virgin Statue, Divine Mercy & Home Enthronement to the Sacred Heart of Jesus & the Immaculate Heart of Mary - Registration Form