March for Life Registration 2022 Group InformationName of Group Leader(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Group Leader Phone(Required)Group Leader Email(Required) Adult ChaperonesPlease list these individuals by their legal name as listed on the Safe Parish Registry. Please include the group leader in this number.Number of Adult Chaperones(Required)Please enter a number from 1 to 10.Number of Female Chaperones(Required)Number of Male Chaperones(Required)Chaperone 1 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Chaperone 2 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Chaperone 3 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Chaperone 4 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Chaperone 5 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Chaperone 6 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Chaperone 7 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Chaperone 8 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Chaperone 9 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Chaperone 10 First Last Email PhoneSafe Parish Compliance I have completed Safe Parish Training and am up to date on my bulletins. I have completed Safe Parish Training and have not completed my bulletins. I have not yet completed Safe Parish Training. Students AttendingNumber of Female Students(Required)Please enter a number from 0 to 50.Number of Male Students(Required)Please enter a number from 0 to 50.Total Students(Required)Total Participants(Required)Total Amount Due by November 23This total reflects the $225 per person that is due on November 23. If you have already made a $100 per person deposit, you can subtract that from the total. The final $100 will be due by Monday, December 20. Price: $225.00 Number
