Reservation Form
Fr. David Rider Pilgrimage: July 10-18, 2024

 Pilgrimage Information:
Departure Date
Destination
Departure/Return City Airports
I am a parishioner of Sacred Heart St. Patrick's Parish:   Yes    Other

 Reservation Made By:
First Name *
Last Name *
Address *
 
City * State *  Zip *
Telephone Number (best number to reach you)
Fax
E-Mail *

 Pilgrimage Options:
Land Only (No Flights) $1195
 Single Room Option $200
 Optional Insurance Quote Yes

 Passenger Information:
All accommodations assume two or three persons per room. If you are traveling alone, you will need the "Single Room" option, which is an additional $200.
Please check the "Single Room Option" box above. Your passport MUST be valid for 6 months after your return (January 18, 2025)
Number of Travelers
Emergency Contact Information

In Case of an Emergency please provide us with a name, phone number, and email address of someone we can contact.

Name: *                     Phone: *
Email: *

Enrollment in the tour constitutes your acceptance of the program Terms and Conditions.

Once we receive your Reservation Form, we will contact you with deposit options.
Medjugorje Web 772 N Peace Rd. DeKalb, IL 60115
877.Web.Medj (932-6335)
815.333.2338 Fax
Email: sshawl@medjweb.com