St. Philomena Walking Pilgrimage Registration Form
Deadline is August 4, 2020

The registration fee is to cover costs of transportation, food, water, toilets, etc.
It can be paid by eTransfer or cheque and made payable to St. Philomena Walking Pilgrimage.

eTransfers can be sent to dave@stphilomena.ca
If you need to create a Security Question use "What town is our destination?"
Set the Password as "Rama"

Or send mail to St. Philomena Walking Pilgrimage
c/o Dave and Bev Hudy
R.R.#1
Melville, Sk. S0A 2P0

TO REGISTER by Email or Phone or at our Website
Contact Deacon Dave and Bev Hudy at
dave@stphilomena.ca at 306-728-5525
www.stphilomena.ca
Last Name *
First Name *
Email *
Phone Number *
Emergency Contact Name *
Emergency Contact Phone *
Home Parish
Youth Attending (Under 18)
List any youth (under 18 years of age) who will accompany you on the pilgrimage. Each youth is required to register separately.
Registration Fee
Registration Fee [without Wednesday meals] $60/adult, $20.00/ages 6-16, free/ages under 6.

If you wish to participate in the two Wednesday meals which are not provided please add $8 for breakfast at Buchanan for adults, $4 or breakfasts for those age 12 or less, and-or, $13 for the supper at Rama for adults, $7 for ages 6-12, and no charge for those under 6

Total price with all meals $81/adult, $41/ages 13-16, $31/ages 6-12, no charge for ages under 6
Amount Sent
Participant Info
If you are unable to make the whole pilgrimage, you are still most welcome, but please let us know here when you will arrive and depart.
Will you take the bus from Rama to Yorkton on the first morning of the pilgrimage? (required)
Clear selection
Health and Safety – To the best of your knowledge are there any health concerns that could restrict your participation in the pilgrimage? If there are, please explain.
Please list if you require special meal needs such as gluten free or vegetarian diets.
T-Shirt Gender
Clear selection
T-shirt size
Clear selection
RELEASE/WAIVER
Participants under 18 years of age must be accompanied by their parent(s), grandparent(s), or another family member over the age of 18 (the “Guardian”). The Guardian agrees to the following terms on behalf of any such participants under 18 years of age as well as on behalf of themselves.

1 . Assumption of Risk - All activities involve a certain amount of risk, and I understand that many of these risks are unpredictable and are wholly outside the control of the Archdiocese, and they may change and increase beyond what is now known, anticipated or expected. In the event of accident, personal injury of any sort, death and/or loss or damage to property the Archdiocese, its employees and volunteers shall not be responsible nor held liable in any way for any such accident, injury, death, loss or damage.

2. Assumption of Risk and Release of Claims - Knowing the risks, and in consideration of being permitted to participate in this event, I agree, on behalf of myself, my family, heirs, and personal representative(s), and on behalf of any such participants under 18 years of age, to assume all the risks and responsibilities surrounding my participation in this event. To the maximum extent permitted by law, I do voluntarily and without reservation, and on behalf of myself, my heirs and my estate, and on behalf of any such participants under 18 years of age release, hold harmless, and indemnify the Archdiocese and its officers, employees, agents and volunteers, from and against any present or future claims, damages, expenses, actions, losses or liability of whatever kind including but not limited to personal injury, injury to property, or injury for which I may be liable to any other person relating in any way to this event, caused by the negligence or other actions of the Archdiocese or any other party including the risks discussed and assumed in this Agreement. I hereby expressly agree that this document shall forever be a complete bar to the commencement or prosecution of any action or proceeding whatsoever against the Archdiocese and its officers, employees, agents and volunteers and this document may be treated as a complete defence to any such action or proceeding brought by anyone on my behalf.

3. Personal Responsibility
a. I will participate in this activity, and will ensure that any such participants under 18 years of age will participate in this activity, in a mature and responsible fashion.
b. I understand that the possession or consumption of alcohol and illegal drugs is prohibited and I will not be permitted to participate in the event while under the influence of alcohol or illegal drugs.

4. Publicity Consent - I grant the Archdiocese and its agent's permission to reproduce and use for educational or other purposes all photographs, videos, or sound recordings of me taken during this event.

5. Acknowledgement - I have carefully read this document before agreeing to it. I understand that this is a Release of Legal Rights and I have been given the opportunity to obtain independent legal advice prior to agreement. I am voluntarily entering into this Agreement and no representations, statements or inducements, oral or written, apart from the foregoing written statement have been made. This Agreement is effective immediately upon submission of the form and shall be governed by the laws of the Province of Saskatchewan.
I agree to the RELEASE/WAIVER *
Required
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