Registration Form

Young Adult Pilgrimage to Italy 2015

Name: *
E-mail: *
Confirm E-mail: *
Date of Birth YYYY-MM-DD: *
Phone: *
Permanent Mailing Address: *
Do you currently have a valid passport? (If you do not, or if your current passport will expire before 1 June 2015, please apply for a new one) *

In case of emergency, please contact:

Emergency Contact Name: *
Relation to me: *
Home Phone: *
Cell Phone: *

Special Needs

I am in good health and am able to hike a mountain and walk on uneven city roads without needing help. *
I have the following allergies or preexisting medical conditions that you should know about (food or medicine allergies, asthma, etc):
I understand that the lodging will partly be in private homes and partly in religious hostels, and that I will have to share the room with one or more people of my same gender *
Do you speak Italian? 1 - 4 : *
I understand that priority in signing up is given to non-married individuals. Are you married or plan to be married by June 19th, 2015? *

If you are married or plan to be married by the time the pilgrimage takes place, please email us at and we will add your name to the waiting list and/or provide info for another simultaneous pilgrimage organized by us AVI that has no age/status limitations . Thank you!

I understand that the $1,200 total cost includes all lodging, 2 meals per day, tour guides and all transportation in Italy. It does not include airfare to/from Italy
I understand that my initial deposit of $400 is non-refundable. *
I understand that if I am unable to travel I will not be reimbursed the amount paid. I therefore accept Trip Insurance as provided by Travel Guard which will reimburse me if I cancel for medical or allowed reasons (Cost of $48.00 per person) (Insurance must be purchased with initial deposit.) For detailed info on the Trip Insurance, please visit *
By signing this form and paying the deposit for this tour I hereby confirm that I have read and understood the Terms and Conditions of this Pilgrimage. *