Westminster Youth Ministry Registration Form | dowym.com | 0207 529 8633

Pilgrim Registration Form

WORLDYOUTHDAYKRAKOW 2016

18to31July

Please read the following information before filling in the registration form:

There are 10 sections in this registration form.

All pilgrims must complete sections 1, 2, 6, 8, 10 and either 4 or 5.

Section 3 applies only to those registering for the 16+ option.

Section 7 applies only to those who may have to check their Visa.

Section 9 applies only to those with special requirements that the Westminster Youth Ministry team will need to know about, such as dietary needs etc.

Deadline:

The deadline for completing the registration form is 27May 2016.

On completion of the registration form:

A deposit of £100 is required with the registration form.

The registration form can be sent to:Westminster Youth Ministry, 20 Phoenix Road, Euston, London, NW1 1TA

Alternatively, it can be sent to:

Payment:

There will be four payments to make for whichever pilgrimage option to choose.

If you wish tosendthepayments electronically, pleaseusethefollowingbankdetails:

Bankaccount:81672134

Sortcode:400520

Accountname:WRCDT Youth Pilgrimages

If you wish to pay by cheque, please make them payable to ‘WRCDT Youth Pilgrimages’ and send them to the above address.

Required forms:

After completing this registration form, the following additional form(s) will be sent to you for your completion:

Medical form (for both pilgrimage options)

Parental consent form (for those under the age of 18)

1 Personal details

Please fill in all the boxes in this section.

Title / Mr / Mrs / Ms / Dr / Revd / Fr / Sr / Other
Name
Address
Postcode
Email
Parish
Town
Home number
Mobile number
Date of birth
Day/Month/Year
Passport number
Nationality
Country of issue
Date of issue
Day/Month/Year
Date of expiry*
Day/Month/Year

* Pleasenote:your passportmust bevalidforthe entireperiodofthepilgrimage and must have at least six months remaining upon arriving back in England.

2 Emergency contact

Please fill in all the boxes in this section.

Title / Mr / Mrs / Ms / Dr / Revd / Fr / Sr / Other
Name
Address
Postcode
Email
Home number
Mobile number
How is this person related to you?

3Group leaders

This section applies only to those registering for the 16+ option. If you are 18+, skip this section and move on to section 4.

Are you a Group Leader, or acting as aResponsible Adult, with a pilgrim group?Yes / No

Are youresponsible for any under 18 pilgrims?Yes / No

If you are under 18 please confirm the name of your group leader below:

4 Pilgrimage Option 1 (16+)

Option 1 is for those aged between the ages of 16 and 35. It includes the full two weeks, including the Mission Week (otherwise known as Days in the Diocese) in Lodz, followed by the World Youth Day week in Krakow. The costs include travel, food, accommodation, WYD passes and transfers in Poland. Travel is by coach. Travel insurance is not included.

We leave on Monday 18 July from Euston. We arrive back in England on Monday 1 August.

Finance

Option 1 willcost £750. Someparishes haveagreedtosponsortheir pilgrim(s) forthe whole orsomeof this amount. Otherpilgrimswill bemeetingthiscost themselves.Pleaseindicatehow your costsare to bemetby tickingtheappropriate box.Pleaseread thenotesconcerningthedeposit,interimandfinalpaymentsand note that a non-refundable deposit of £100shouldbereturnedwiththisregistration form unlessyourparish iscoveringallyour costs.

I am responsible for meeting the full cost of this trip
I am responsible for part of the costs of this trip
My parish has agreed to contribute (£):
Please clarify with your parish priest how much your parish will contribute and complete the above. How your payments are made – whether it is by cheques from you, the parish or a combination of both – will depend on the amount your parish is contributing.
My parish has agreed to cover the whole cost of £750
Please complete and return this registration form only. Payment will be arranged with your parish priest directly.

Payments

Payment 1: £100 deposit (payable to WRCDT, submitted with this form)

Payment 2: £200 by 31 March 2016

Payment 3: £200 by 30 April 2016

Payment 4: £250 by 30 June 2016

Please select your payment method:Electronic transfer / Cheque

5 Pilgrimage Option 2 (18+ only)

Option 2is for those aged between the ages of 18 and 35. It includes only the World Youth Day week in Krakow. The costs include travel, food, accommodation, WYD passes and transfers in Poland. Travel is by coach. Travel insurance is not included.

We leave on Sunday 24 July from Euston. We arrive back in England on Monday 1 August.

Finance

Option 2 willcost £675. Someparishes haveagreedtosponsortheir pilgrim(s) forthe whole orsomeof this amount. Otherpilgrimswill bemeetingthiscost themselves.Pleaseindicatehow your costsare to bemetby tickingtheappropriate box.Pleaseread thenotesconcerningthedeposit,interimandfinalpaymentsand note that a non-refundable deposit of £100shouldbereturnedwiththisregistration form unlessyourparish iscoveringallyour costs.

I am responsible for meeting the full cost of this trip
I am responsible for part of the costs of this trip
My parish has agreed to contribute (£):
Please clarify with your parish priest how much your parish will contribute and complete the above. How your payments are made – whether it is by cheques from you, the parish or a combination of both – will depend on the amount your parish is contributing.
My parish has agreed to cover the whole cost of £675
Please complete and return this registration form only. Payment will be arranged with your parish priest directly.

Payments

Payment 1: £100 deposit (payable to WRCDT, submitted with this form)

Payment 2: £200 by 31 March 2016

Payment 3: £200 by 30 April 2016

Payment 4: £175 by 30 June 2016

Please select your payment method:Electronic transfer / Cheque

6Insurance

Grouptravelandmedicalinsuranceis notincludedin theoverallcost.You will need toarrangeyourown insurance,but pleasesupplytheinformationto us by filling in all the boxes below.

Company or Companies you are insured with
Policy number(s)

People living within the European Union should bring their European Health Insurance Card (EHIC). More information can be found at:

7Visas

This section applies only to those who may have to apply for a Visa. If you are holding a British passport, you do not require a Visa and can skip this section.

If you require a Visa for the pilgrimage, please complete the necessary steps.

Information about Visas can be found at:

8 T-Shirt

Every pilgrim will be given a free Westminster Youth Ministry t-shirt as part of their pilgrim pack. Please select the size which best fits you:

My t-shirt size is:Small / Medium / Large

9 Special requirements

This section applies only to those with special requirements. If you do not have any, skip this section.

Please specify below any information or special requirements you may have in order for us to best assist in providing you with your pilgrimage.

10Signature and date

Please sign and date your registration form in the space provided below.

SignatureDate

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