LOURDES PILGRIMAGE 2017 BOOKING AND CONSENT FORM LPF001/LPF002 The Pilgrimage is fully booked. Please do not complete this form unless you have been asked to register. Contact Gaye on 01 6140033 or at omac@orderofmalta.ie for enquiries.
Pilgrim, Pilgrimage Staff and Malade Booking Form LPF001/LPF002
Title
Your answer
First Name(s) (as per Passport - include middle name if shown on Passport)
Your answer
Surname (As per Passport)
Your answer
Phone Number(s)
Your answer
Current Address
Your answer
Email Address
Your answer
Please select your home county from the list below
Date of Birth (mm/dd/yy)
MM
/
DD
/
YYYY
Gender
Religion
Your answer
Are you
Travelling with
Please indicate if you are traveling with an Order of Malta Unit, A family Group or a Parish/organised group
Please state the Name of the Unit/Parish/Group (If in a group)/Name of Organiser (name of person applying on your behalf)
Your answer
Next of Kin contact details
Please give the Name, Address and contact phone number of your next of kin
Your answer
PILGRIMS STAFF AND MALADE
All persons travelling please complete section below
Please select your flight options
If making your own way to Lourdes
Arrival Date
MM
/
DD
/
YYYY
If making your own way to Lourdes
Departure Date
MM
/
DD
/
YYYY
Accommodation Type
Accommodation Preference (Hotel Padoue is fully booked. All hotel bookings will be for Roissy)
If looking after your own accommodation please supply address
Your answer
Room Type Preference (Hotels only)
Hotel only: If you have selected a sharing room, please list names of other guests sharing with you (if known)
If not selected, we will allocate persons to share
Your answer
Do you hold a valid European Health Insurance Card for the Period of the 5th May to the 10th May 2017
Advanced Passenger Information System Details
It is a requirement that all passengers must supply Advanced Passenger Information to the Airline which may be shared with the Police aux Frontières (The Border Police of the Republic of France). All passengers must answer the below questions accurately. Please ensure your name above is an exact match for your passport details.
Do you hold a valid passport to travel with in the European union?
Document Type
Your Nationality
Select from the most common options, or type a response
Your country of Residents (usual residence)
Your answer
Passport / Passport Card Number
Usually shown in the top right corner of the document. Irish Passport numbers usually begin with a "P" and up to eight other letters or digits.
Your answer
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