Saint Gemma’s

Catholic Pilgrimages

www.TakeaPilgrimage.com

 

Registration Form

 

  • Send Completed form to: Saint Gemma’s Catholic Pilgrimages, P.O. Box 128, Spring Brook, NY 14140
  • Please contact us with any questions at: 855-710-7663, 716-652-0515 or Rome@TakeaPilgrimage.com

 

Select one Pilgrimage in 2014:

               

___ February 15-23: Rome & Assisi - 9 Days: $2695, Fr. Jim Ciupek

___ April 25 – May 2: Rome & Assisi – Canonization of John Paul II: $2995 double occupancy

___ April 25 – May 2: Rome & Assisi – Canonization of John Paul II: $3295 single occupancy

___ September 22 - October 3: Rome, Florence & Naples - 12 Days: $2995

___ October 6-17: Rome, Assisi & Orvieto - 12 Days: $2995

___ October 18-26: Rome & Florence - 9 Days: $2695

 

Name                                                                                                                            

                        First                                                                                                     Last    

 

Street Address                                                                                                              

 

City                                                                      State/Province                                  

 

Postal/Zip Code                                                    Country                                                     

 

Email                                                                     Phone                                                         

 

Payments: 

  • We will mail you an invoice.
  • PLEASE NOTE: A 3% service charge is added to payments made through Paypal.com. 
  • A $300 deposit is due with registration and counts toward your total fee. 
  • Final payment is due 90 days before departure. 

 

 

 

How will you be paying?       

___ I will send a check for my deposit and final payment.

___ I will send a check for my deposit and use paypal.com to make my final payment.

___ I will use paypal.com to make my deposit and send a check for my final payment

___ I will use paypal.com for my deposit and final payment.

 

Name as it appears on your passport:

 

                                                                                                                                     

(Needed by airlines to verify identity when you check in.  You can send this later if you don't have a passport yet)

 

Date of Birth:                                                      

(Needed by airlines to verify identity when you check in)

 

How did you hear about us?

 

___ Online search

___ Catholic radio

___ Church

___ Link on Catholic website

___ Catholic periodical

___ Friend/family

___ Facebook

___ Catholic bookstore

___ Other

 

Additional information or Promo Code: 

·         If part of a Pilgrimage Group (Catholic parish or other Catholic group going together) please include the name of your group here. 

·         Please include any additional information you wish us to know.