Pilgrimage to the Shrine of
Our Lady of Guadalupe Registration

Name as in passport(Required)

First Middle Last

Phone(Required)

Email(Required)

Skymiles number

Known Traveler Number (TSA or Global Entry)

Date of Birth(Required)

Emergency Contact Name(Required)

First Last

Emergency Contact Phone Number(Required)

Any medical conditions (if none please write NONE)(Required)

Do you have any problems walking long distances?(Required)

Yes

Other

Roommate Preference

Do you have a valid US Passport that will not expire within 6 months of the travel time?(Required)

Yes

Applying for a passport

NON-REFUNDABLE DEPOSIT

Price:

If you would like to help the church in paying for the 3.5% processing fees please click YES below

YES

CC Processing Fees

Price: $0.00

Total

Address(Required)

Street Address City State ZIP Code

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Pilgrimage to the Shrine ofOur Lady of Guadalupe Registration