Youth Registration

Registration for the 2019 Pilgrimage to D.C. is now closed. If you would like to inquire about any available openings, please email youth@prolifedallas.org or call Jacquelyn Smith at 469-399-7495.

This trip is open to youth in grades 9-12 and/or ages 14-18 (provided they are still in high school).

Please complete the following form to register for the trip.

Any registration received by midnight on November 6 is eligible for the early deposit price of $290. 

Please note: The registration deposit must be paid by November 13. All registrations (including payment) received after November 6 must pay he $315 deposit price. 

All deposits are non-refundable once airline tickets are purchased approximately the first week of December unless a paying replacement can be found. Due to space limitations at our place of lodging, the replacement may have to be the same sex as the person canceling.

Payment plans are an option for paying your trip fee and airline ticket provided the balance is paid off by June 30, 2019.

All youth, with at least one of their parents, are required to attend a mandatory meeting to be held in January 5, 2019.  


First Name*
Last Name*
Address*
City*
State*
Zip Code*
Phone*
E-Mail*
Age*
Date of Birth*
Grade*
Sex*
Sweatshirt Size*
School*
Church*
Parent's Name*
Parent's Phone*
Parent's E-Mail*
If you are coming as part of a group, please give the name of the group.*
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