REGISTRATION FORM FOR OCTOBER 21st, 2025 PILGRIMAGE TO MEDJUGORJE FULL NAME (as it appears on your passport) * First Name Last Name Date of Birth * MM DD YYYY Gender Male Female Departure Airport Do you need a single room (extra charge) ? YES NO Name of person you will share a room with Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone (###) ### #### Emergency contact (person not traveling with you) Passport expiration date MM DD YYYY NOTES and SPECIAL REQUESTS Thank you for registering.A confirmation and payment link will be sent to you as soon as possible.If you have any questions, please contact us at croatia@mircenter.com
