Event Request Form

Name(Required)

First Last

Email(Required)

Phone(Required)

Ext.

Event Date(Required)

Event Time

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 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

Tour Information

Is a guided tour requested?(Required)

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 that apply.

Mass — Rosary &mdash Other Devotion

Attending Noon Mass?(Required)

Alternate Mass Time Requested

Subject to approval.

Is a Priest needed?(Required)

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)

Pilgrim Center & Pavilion

Is the Father Lopez Meeting Room requested?(Required)

Meeting Room Hours(Required)

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)

A/V Equipment Requirments

Projector

Microphone

Speakers

Are tablecloths needed?(Required)

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)

Where will the caterer be setting up?(Required)

Is coffee service needed?(Required)

Coffee service is complimentary.

Will you be using the picnic tables at the pavilion?(Required)

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.