March for Life 2022

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Sex REQUIRED Male Female Please fill out this field.

Street Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Best phone number REQUIRED Please fill out this field. Please enter a phone number.

Best Email REQUIRED Please fill out this field. Please enter an email address.

Home parish REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

T-shirt Size REQUIRED Small Medium Large XL XXL Please fill out this field.

Hotel Preferences REQUIRED Quad occupancy. Please assign me to a room with 3 others at your discretion Quad occupancy. Please assign me to a room with the participants I list below. I am registering for $455 so that I can have my own bed (I understand that I will be assigned two roommates). My spouse and I would like to room alone for $890 ($375+$355+$160 duo-occupancy upgrade). I am staying with my entire family in one room Please fill out this field.

Roommate Preferences (you may list up to 3)

Safe Environment Policy
All non-parent chaperones of students under 18 years old must complete the VIRTUS safe environment training online and must be cleared through a background check (see instructions below). This must be completed by December 1st.
• With exceptions of families, men may only room with men and women with women.
• A duo-occupancy upgrade fee may be paid by MARRIED couples who would like to room alone together or in the case of a child with relative(s).
• Please note we cannot room non-related youth (under 18) with adults (anyone 18 and older). This will be strictly enforced.
• Families may room together (although no additional beds are allowed in the rooms according to Washington, DC ordinance. If a family wants to room together and has more than four members please keep this in mind)

I agree to follow the safe environment policy Please select this field.

For Youth under 18 years old
Each youth must have a designate chaperone. Please complete the information below:

Name of chaperone Please enter valid data.

Record of Virtus training on file Yes No

I need info about how to get VIRTUS trained Yes No

Chaperone cell phone number Please enter a phone number.

Relationship to youth Parent/guardian Youth Leader Other I do not have a chaperone, please assign me one

Parent permission for youth under 18

If you would like your child or ward to participate in this event, please read and acknowledge the following statement of consent and release of liability. As parent or legal guardian, you remain fully responsible for the actions and conduct of your child.

I hereby consent to participation by my son, daughter, or legal ward in this event. I understand this event will take place away from parish grounds and my child will be under the supervision of designated adults on the stated dates. I further consent to the conditions stated above on participation in this event, including the method of transportation.

In consideration of my child being allowed to participate in this activity, I hereby agree on behalf of myself and my child, to release the individuals in charge, the Roman Catholic Diocese of Marquette, St. John the Evangelist and St. Joseph parishes, and any and all affiliated organizations, their employees, agents and representatives, including volunteer drivers (collectively “Releases”) from any and all claims, including negligence, which may be asserted by me or my child, or on behalf of my child, arising from or relating to my child’s participation in this activity. In the event this release on behalf of myself and/or my child is held to be invalid or unenforceable, I hereby agree to indemnify and hold harmless Releases from any and all claims, including negligence, which may be asserted by me or my child, or on behalf of my child, arising from or relating to my child’s participation in the activity.

This release or indemnification does not apply to claims for intentional misconduct or gross negligence; nor does this release or indemnification apply to the extent of commercial insurance coverage for any claim, but this Release or Indemnification shall apply to the extent of any self-insurance or deductible applicable to any claim.

I consent to the above permission Yes

Parent or guardian providing this consent Please enter valid data.

Email for record of this consent Please enter an email address.

For everyone: Code of Behavior
This code of behavior has been developed to help participants understand what is expected of them during the event and to make the experience a healthy, positive, and worthy one for all involved. Please read through the code carefully, as you will be expected to honor and uphold it throughout your time with us.
• We expect each person to have a cooperative attitude and work together for the common good in order to make this event successful.
• We will treat all facilities with respect, as we would treat our own home.
• No visiting is allowed in sleeping areas occupied by the opposite sex. Men will be assigned to rooms with other men, and women with women. The two exceptions to this rule are families and married couples.
• There is no smoking/tobacco use in building(s). (Smoking/tobacco use is allowed outside, if you are of legal age).
• Consumption of alcohol is not permitted on the bus and not permitted if you are under the legal age.
• The purchase, possession, or consumption of illegal drugs by participants will result in immediate dismissal from the pilgrimage. The possession of drug paraphernalia will also result in immediate dismissal. You will be dismissed and need to be picked up via your own personal contacts.
• Please keep the pilgrimage leadership team aware of your intended location while on the pilgrimage in order to assist us in making sure everybody makes it home safely.

I have read and agree to follow the Code of Behavior Please select this field.

For everyone: Emergency Contact Info

Emergency contact person REQUIRED Please fill out this field. Please enter valid data.

Emergency contact phone number REQUIRED Please fill out this field. Please enter a phone number.

Family physician REQUIRED Please fill out this field. Please enter valid data.

Physician Phone Number REQUIRED Please fill out this field. Please enter a phone number.

List allergies, medications, other pertinent info REQUIRED Please fill out this field.

Health insurance company REQUIRED Please fill out this field. Please enter valid data.

Health insurance policy number REQUIRED Please fill out this field. Please enter valid data.

Other health insurance info

This information is completed of my own free will for the sole purpose of authorizing medical treament in emergency circumstances (Adult pilgrim or Parent/Guardian of minor pilgrim).

I Agree Please select this field.

Select payment amount REQUIRED 50.0 – Trip Deposit 375.0 – Quad-occupancy full amount due December 17th 455.0 – Full amount with my own bed due December 17th Please fill out this field.

Ishpeming Catholic

St. John and St. Joseph Parishes

March for Life 2022

Join us January 19-23, 2022 to D.C.!

Register Online