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Menu Toggle
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Event Request Form
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1
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6
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Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Ext.
Event Date
(Required)
Month
Day
Year
Event Time
Hours
:
Minutes
AM
PM
AM/PM
Type of Event
(Required)
Event Topic
Group Information
Group Name
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Country
Diocese
School
Feel free to include a grade or range of grades.
Tour Company
Approximate Group Size
(Required)
Group Type
(Required)
Youth
Adults
Seniors
Select All
Tour Information
Is a guided tour requested?
(Required)
Yes
No
A guided walking tour of the grounds may be included during your event. Our Pilgrimage Coordinator will work with you to best accommodate this request.
Guided Tour Locations
Mission Grounds
Shrine Church
Museum
Select All
Select all that apply.
Mass — Rosary &mdash Other Devotion
Attending Noon Mass?
(Required)
Yes
No
Alternate Mass Time Requested
Hours
:
Minutes
AM
PM
AM/PM
Subject to approval.
Is a Priest needed?
(Required)
Yes
No, we will provide our own Priest.
Priest Name
(Required)
First
Last
Suffix
A Letter of Good Standing must be provided and approved through the Diocese of St. Augustine Chancery. Please submit at least two weeks prior to your event.
(Required)
I understand.
By checking this box, I understand that a 'Letter of Good Standing' must be provided through the Diocese of St. Augustine Chancery. Activities including but not limited to the celebration of the Mass or any priestly or religious involvement may only take place pending approval of the Chancellor and in agreement with the Shrine Rector.
Is the Rustic Altar requested?
(Required)
Yes
No
Pilgrim Center & Pavilion
Is the Father Lopez Meeting Room requested?
(Required)
Yes
No
Meeting Room Hours
(Required)
Full Day - $350 - 9 AM to 5 PM
Half Day - $250 - 9 AM to 1 PM
Sunday - $250 - 12 PM to 4 PM
Deposit Policy
(Required)
I agree to the deposit policy.
I understand a $100 non-refundable deposit is due in order to secure my reservation and hold the date for my event. This deposit will be applied toward the overall cost of using the meeting room.
Room Arrangement
(Required)
Banquet
Lecture
Seats Only
A/V Equipment Requirments
Projector
Microphone
Speakers
Select All
Are tablecloths needed?
(Required)
Yes
No
A $25 service fee applies for use of our tablecloths. You may provide your own for no charge.
Food & Beverage
Please note:
: we do not provide food or beverages.
Are you using a caterer?
(Required)
Yes
No
Where will the caterer be setting up?
(Required)
Foyer
Meeting Room
Is coffee service needed?
(Required)
Yes
No
Coffee service is complimentary.
Will you be using the picnic tables at the pavilion?
(Required)
Yes
No
Final Comments, Questions, and Notes
Comments / Questions / Notes
Facility Use Donations
(Required)
I understand the donation policy.
I understand for my request of a tour, or Mass, a $100 gift is suggested and a tax-exempt letter is required.
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