PA March for Life 2025 Registration if paying with credit card Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone(Required)Email(Required) Parish(Required)Please select your parish from the drop down menu below:Christ the King Parish – ArchbaldSaint Leo Parish – AshleyQueen of the Apostles Parish – AvocaSaint Elizabeth Parish – Bear CreekOur Lady Queen of Peace Parish – BrodheadsvilleSaint Michael Parish – CantonOur Lady of the Rosary Parish – CarbondaleSaint Frances X. Cabrini Parish – CarvertonSaint Gregory Parish – Clarks GreenOur Lady of the Snows Parish – Clarks SummitSaint John Bosco Parish – ConynghamMost Holy Trinity Parish – CrescoGate of Heaven Parish – DallasOur Lady of the Abingtons Parish – DaltonVisitation of the B.V.M. Parish – Dickson CityOur Lady Help of Christians Parish – DorranceGood Shepherd Parish – DrumsOur Lady of Mount Carmel Parish- DunmoreSaints Anthony & Rocco Parish – DunmoreSacred Heart of Jesus Parish – DupontNativity of Our Lord Parish – DuryeaImmaculate Heart of Mary Parish – DushoreSaint John Parish – East StroudsburgSaint Matthew Parish – East StroudsburgSaint Thomas the Apostle Parish – ElklandSaint Barbara Parish – ExeterAscension Parish – Forest CityOur Lady of the Immaculate Conception Parish – FreelandSaint Brigid Parish – FriendsvilleHoly Spirit Parish – Glen LyonSaint Rita Parish – GouldsboroExaltation of the Holy Cross Parish – Hanover Twp.Our Lady of Victory Parish – Harveys LakeBlessed Virgin Mary, Queen of Peace Parish – HawleySaint John Neumann Parish – HawleySaint Pius of Pietrelcina Parish – HazletonHoly Rosary Parish – HazletonOur Lady of Peace Parish – HazletonQueen of Heaven Parish – HazletonSaints Cyril & Methodius Parish – HazletonSaint John the Evangelist Parish – HonesdaleOur Lady of Mt. Carmel Parish – Hunlock CreekSacred Hearts of Jesus and Mary Parish – JermynSaint Luke Parish – Jersey ShoreQueen of Angels Parish – JessupSaint Ignatius Loyola Parish – KingstonSaint Maria Goretti Parish – LaflinSaint Thomas More Parish – Lake ArielSaint Mary of the Lake Parish – Lake WinolaSaint John the Baptist Parish – LarksvilleHoly Family Parish – LuzerneHoly Child Parish – MansfieldSaint Joseph Parish – MatamorasSaint Patrick Parish – MilfordSaint Vincent de Paul Parish – MilfordOur Lady of Lourdes Parish – MontoursvilleHoly Name of Mary Parish – MontroseSaint Catherine of Siena Parish – MoscowSaint Jude Parish – Mountain TopResurrection Parish – MuncySaint Faustina Kowalska Parish – NanticokeSaint Patrick Parish – NicholsonPrince of Peace Parish – Old ForgeBlessed Carlo Acutis Parish – OlyphantSacred Heart of Jesus Parish – PeckvilleSaint Joseph Marello Parish – PittstonOur Lady of the Eucharist Parish – PittstonSaint John the Evangelist Parish – PittstonSaints Peter & Paul Parish – PlainsSaint Katharine Drexel Parish – Pleasant MountAll Saints Parish – PlymouthSaint Maximilian Kolbe Parish – Pocono PinesSaint Eulalia Parish – Roaring Brook TownshipEpiphany Parish – SayreSaint John Vianney Parish – Scott TownshipCathedral of Saint Peter – ScrantonDivine Mercy Parish – ScrantonMary, Mother of God Parish – ScrantonImmaculate Conception Parish – ScrantonSaint Teresa of Calcutta Parish – ScrantonSaint Ann Basilica Parish – ScrantonSaint Patrick Parish – ScrantonSaint Paul Parish – ScrantonSaint Therese Parish – ShavertownSaint Ann Parish – ShoholaSaint Lawrence Parish – South WilliamsportSaint Luke Parish – StroudsburgHoly Family Parish – Sugar NotchMost Holy Trinity Parish – SusquehannaSaint Elizabeth Ann Seton Parish – SwoyersvilleOur Lady of Victory Parish – TannersvilleBlessed Sacrament Parish – ThroopSaints Peter and Paul Parish – TowandaNativity of the B.V.M. Parish – TunkhannockSaint Mary Parish -WaymartSaint Peter Parish – WellsboroHoly Name of Jesus Parish – West HazletonSacred Heart of Jesus Parish – WestonCorpus Christi Parish – West PittstonSaint Monica Parish – West WyomingSaint Patrick Parish- White HavenOur Lady of Hope Parish- Wilkes-BarreSaint Andrew Parish – Wilkes-BarreSaint Nicholas/Saint Mary Parish- Wilkes-BarreSaint Robert Bellarmine Parish- Wilkes-BarreImmaculate Conception of the B.V.M. Parish – WilliamsportSaint Ann Parish – WilliamsportSaint Boniface Parish – WilliamsportSaint Joseph the Worker Parish – WilliamsportOur Lady of Perpetual Help Parish – WyalusingAge(Required) Under 18 18 or older Preferred Pick-Up Spot:(Required) Divine Mercy Parish, Scranton St. Nicholas-St. Mary Parish, Wilkes-Barre T-shirt SizeAny Medical or Accessibility Concerns or Needs(Required)Emergency Contact(Required) First Last Relationship to you:(Required)Emergency Contact Phone Number(Required)Consent(Required) I agree to the Waiver and Release of Liability:The participant agrees to indemnify and hold harmless the Diocese of Scranton, their agents, employees and volunteers, from and against all claims, demands, suits, causes of action, bodily injuries, property damages, losses, penalties, and/or expenses, including attorney’s fees, arising out of or resulting from any and all actions, accidents, and events caused or incurred by the Participant in connection with participation or attendance at, the Pennsylvania March for Life. The Participant agrees to assume the entire responsibility and liability for all damages or injuries to himself/herself and all other persons and to all property arising out of the event or in any manner connected with the Diocese of Scranton due to his/her actions, negligence, or alleged negligence, and to the fullest extent permitted by law, the Participant shall defend and indemnify the Diocese of Scranton, its agents, volunteers, and attorneys from all claims and Participant further agrees to pay all damages and costs resulting from any claim including reimbursement to the Diocese of Scranton. The Participant further agrees to notify the Diocese and its agents and volunteers, of any health or physical concern before the date of the event. Examples include but are not limited to: allergies (insect stings or plants), pregnancy, motion sickness, or any disabilities that would prevent or affect physical activity. This release confirms the Participant’s understanding that his/her participation in the activity is on an individual and voluntary basis, at the Participant’s own risk, for the Participant’s personal benefit, and the Participant is solely responsible for his/her well-being and personal property. The terms of this release are binding on the Participant’s heirs, executors, administrators, and assignees. By submitting this form, the participant signifies that he/she has read and understands the terms of this form and the agreement. Participant agrees to abide by policies and directives of the Diocese of Scranton, and the direction of administrators of this particular event.PA March for Life Registration Fee – $20.00 Price: Δ