PA March for Life Registration if paying with credit card

IMPORTANT: Please note that when you submit this form, you will be taken to the PayPal page where you will have the option of paying with a PayPal account or with a credit/debit card. If you don’t have a PayPal account, simply click on the button that reads “Pay with Debit or Credit Card”.

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 Country

Phone(Required)

Email(Required)

Parish(Required)

Age(Required)

Under 18

18 or older

Preferred Pick-Up Spot:(Required)

Divine Mercy Parish, Scranton

St. Nicholas-St. Mary Parish, Wilkes-Barre

T-shirt Size

Any 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: