We are excited to have you join us !
This form is only to be submitted if you are ready to fully commit to being a pilgrim for WYD 2023 in Lisbon!  You will be contacted by one of the Archdiocesan representatives shortly after this form is submitted. Your good faith deposit of $150 must be received within 48 hours. A copy of all your responses will be sent to you shortly after. Must there be any changes to your personal information, please inform us immediately.
Sign in to Google to save your progress. Learn more
Email *
First and Last Name (As it appears on your passport) *
Mailing Address (House # Street/Box Number, City/Town, Province, Postal Code) *
Phone Number *
Birthdate *
Parish (If not affiliated with a parish, please indicate your school/organization/faith involvement)
Participation in World Youth Day (WYD) 2023 involves a commitment of personal time and energy in preparation for the event, and during the event.  Pilgrims are expected to conduct themselves with due respect and to show consideration for their fellow pilgrims, leaders, and volunteers involved in WYD.   *
I understand that I will be at least 18 years of age by July 25th 2023 and I commit to my participation in World Youth Day which includes: Spiritual Preparation Sessions from July 2022 – July 2023, a retreat prior to leaving for Lisbon, Days in the Diocese Activities, WYD Activities in Lisbon *
If you are currently under 18 years of age, you must have a parent or guardian's consent.  We will contact them to receive verbal and written consent. Please state their name, your relationship, and a phone number we can reach them at (e.g: Jane Doe, Mother, xxx-xxx-xxxx)
This information is to ensure the safety of all participants. It will be used by your delegation leader and Medical personnel as needed.
Manitoba Health Registration # (6 digits) *
Manitoba Personal Health ID Number (9 digits) *
Other Medical Insurance (e.g Blue Cross)
Allergies (please list your allergies and your reaction to them)
Current Medications Needed
Special Needs and/or Chronic or Recurring Illness
Emergency Contact
Please include 2 emergency contacts. We highly encourage one being a close family member.
Name, Relationship, Phone # *
Name, Relationship, Phone # *
In case of medical or traumatic emergency, I understand every effort will be made to contact the person(s) above.  In the event they can not be reached and/or I can not express my own wishes, I hereby give permission to the World Youth Day medical personnel to hospitalise, secure proper treatment, order injection, anaesthesia or surgery.  In the event medication, medical advice, treatment and/or equipment are required. I agree to accept financial responsibility of any excess charges that are not covered by Provincial Health and/or Medical Insurance. *
Payments can be received in person at the St. Boniface Archdiocese Pastoral Centre located at 151 ave de la Cathedrale, Winnipeg, MB R2H 0H6.  I will be submitting my $150 good faith deposit to secure my spot on the pilgrim list by: *
I fully understand that my reservation for a spot is not valid until payment has been recevied. I will submit my payment within the next 48 hours in the method said above. *
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy