• Delegate's Basic Information

  • Auto-Generated ID
  • Gender*
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
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  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Sponsoring Lodge Information

  • Format: (000) 000-0000.

  • Delegate's Insurance Information

  • Format: (000) 000-0000.

  • Emergency Contacts

  • Emergency Contact #1

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Emergency Contact #2

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Other Information

  • Is the Delegate between the ages of 16 and 17 with at least one year of high school remaining at the time our trip will begin.*
  • Is the Delegate willing and able to take part in considerable daily walking and stair climbing?*
  • Does the Delegate require special meals for health or religious reasons.*
  • Does the Delegate have any food allergies?*
  • Is the Delegate a member of the Independent Order of Odd Fellows?*

  • Privacy Statement

  • The information contained in this form is used by management of the program to select and administer the program. Except in case of medical emergency, information will not be disclosed to third parties. In the case of medical emergency, information may be released to attending medical personnel. Furnishing this information is voluntary, but failure to do so may prohibit participation in the Program.

  • Required Forms

  •  

     In order to complete your application, IOOF Pilgrimage for Youth requires two forms be filled out by hand to protect the validility and authenticity of the form.

    • One (1) Notarized Statement certifying the information that is contained in this form.
    • One (1) Medical Release and Waiver completed and signed by a physician.

     

    The forms can be accessed below:

     

    Notarized Statement Click Here to Download
    Medical Release and Waiver Click Here to Download

     

    Upon submitting your application, you will be emailed an additional link that can be used to upload these forms once they are filled out.

  • Rules & Regulations

  • The Independent Order of Odd Fellows Pilgrimage for Youth has been in existence since 1949.  During this time, certain rules and regulations have been adopted to ensure the safety and enjoyment of all participants.

    In order to ensure that each of these rules is communicated and acknowledged by all Delegates, please read each of the rules below and click the "I agree" box below it.

  • Signature

  • Should be Empty: