Registration – for Sunday-only events | National Coalition of Clergy and Laity

(Families, individuals & groups registering for more than one day use different forms. Click here to register a family participating for more than one day. Click here to register an individual or group.)

All fields marked * are required.

All events the last day - this year Sunday - take place only at the Auriesville Shrine of Our Lady's Martyrs.

Click here to read about the NEW days & ways of Pilgrimage 2011.

Note well -- Given the new route of Pilgrimage 2011, there are NO EVENTS this year at the National Shrine of Blessed Kateri in Fonda.

My Name *

Age *

Address *

Address 2

City *

State/Province *

Province

Zip/Postal Code *

Country

Phone

Mobile Phone

To which brigade do you belong?

How will you participate in Sunday's events?

arrive by 10:30am at Auriesville Shrine cafeteria parking lot, shuttle to rendezvous point, and walk last 7 miles - NO STROLLERS!

arrive by 12-noon at cafeteria parking lot, walk to rendezvous point along Canalway bike path, and return last few miles - IDEAL FOR STROLLERS!

arrive for 3:15pm Mass only; pray, confess, venerate holy sites

See this page for an explanation of Sunday's options & instructions.

Shuttle volunteer & vehicle?

I volunteer to drive a shuttle

I have a full-size or mini-van

Joining me Sunday-only are the following pilgrims:

Pilgrim 2

Pilgrim 3

Pilgrim 4

Pilgrim 5

Pilgrim 6

Pilgrim 7

Pilgrim 8

Pilgrim 9

Pilgrim 10

PARENTAL AUTHORIZATION FOR MINOR CHILDREN

This section MUST be completed if you will be allowing minor children to participate in the pilgrimage.

Do you have a minor child or minor children participating in the pilgrimage?

Yes

We, the undersigned, residing at:

(address) ,

authorize the "National Coalition of Clergy and Laity" to make all necessary arrangements for any surgical or urgent hospitalization for our child/children:

(names of children) ,

and/or in our absence place all or said child/children, in the care of Mr./Mrs.

(names of guardian/s on pilgrimage) ,

residing at:

(address of guardian/s on pilgrimage) ,

who is/are participating in the Pilgrimage for Restoration 2011 in the same events as our child/children.

Parent 1

Initials

Name of Parent 1

Date

(dd/mm/yyyy)

Parent 2

Initials

Name of Parent 2

Date

(dd/mm/yyyy)

RELEASE OF LIABILITY to be signed by all adult pilgrims:

All pilgrims participate and walk in the Pilgrimage for Restoration 2011 at their own risk. "National Coalition of Clergy & Laity" is not liable or responsible for any injury, illness, death or other mishap incurred or suffered by any pilgrim at any time or in any part of the Pilgrimage for Restoration 2011.

I / We, the undersigned, residing at the above-entered address(es), agree to the Release of Liability statement here above, and release NCCL and pilgrimage organizers from all liability to/for myself/ourselves and/or our children under age 18.

Initials

Pilgrim 1

Full Name of adult pilgrim

Date

Initials

Pilgrim 2

Full Name of adult pilgrim

Date

Initials

Pilgrim 3

Full Name of adult pilgrim

Date

Initials

Pilgrim 4

Full Name of adult pilgrim

Date

Initials

Pilgrim 5

Full Name of adult pilgrim

Date

Initials

Pilgrim 6

Full Name of adult pilgrim

Date

Initials

Pilgrim 7

Full Name of adult pilgrim

Date

Initials

Pilgrim 8

Full Name of adult pilgrim

Date

Initials

Pilgrim 9

Full Name of adult pilgrim

Date

Initials

Pilgrim 10

Full Name of adult pilgrim

Date

All fields marked * are required.