Nebraska High School Pilgrimage Registration

June 9-19, 2024

Welcome to our pilgrimage! You are accessing this page because you have been invited to register for this trip. Registration does not guarantee your booking; if we are able to extend a spot to you, we will send you an email letting you know and providing payment instructions. In order to be considered for a spot, you must complete all the steps and submit the forms and documentation listed below.

Please contact Jaqueline Kane with any questions at:

necatholic2024@lolekpilgrimage.com or (402)416-6264

“It is Jesus who stirs in you the desire to do something great with your lives.”

— St. John Paul II

Step 1: Passport and Registration Form

All participants are required to have a valid passport. As soon as you have your passport, we will need a copy of it for our records.

This website will walk you through the application process for a US Passport: https://travel.state.gov/content/travel/en/passports/how-apply.html

If you’re applying for the first time, you must submit your application in person. The following link will show you the different locations where you can turn in your forms: https://iafdb.travel.state.gov

To apply for a passport you will need the following:

A completed DS-11 form
Evidence of citizenship: Original or certified copy of a US birth certificate
Photocopy of birth certificate, front and back
One form of identification, ex. drivers license, include a front and back photocopy of the ID
Passport photos, bring 2 copies (we recommend getting your photo taken, this can be done at Walmart, Walgreens, etc). Link to information for passport photo requirements: https://travel.state.gov/content/travel/en/passports/how-apply/photos.html

For our trip you will only need a passport book.

Name of Pilgrim

First Name

Last Name

Do you currently have a valid passport?

Yes

No

If you have a passport, have you submitted a printed copy to Lolek?

Yes

No

Passport Number

(If you have a valid passport)

Full Legal Name

(First, Middle, Last)

Date of Birth

MM

DD

YYYY

Participant's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Participant's Email

(if applicable)

Participant's Cell Phone

(if applicable)

(###)

###

####

Participant’s Health Concerns

(allergies, medications, dietary, mobility issues, etc.)

Step 2: Emergency Info & Media Release

Please fill out this form once you have completed Step 1.

YOU MUST USE the same first and last name for “Name of Pilgrim” as you used in Step 1.

Name of Pilgrim

First Name

Last Name

Health Insurance Carrier

Health Insurance Group Number

Mother/Guardian Name

First Name

Last Name

Mother/Guardian Cell Phone

(###)

###

####

Mother/Guardian Email

Mother/Guardian Address

Father/Guardian Name

First Name

Last Name

Father/Guardian Cell Phone

(###)

###

####

Father/Guardian Email

Father/Guardian Address

Emergency Contact Name and Relationship to Pilgrim

(If parents cannot be reached)

Emergency Contact Phone

(###)

###

####

I realize that photographs, videos, written extractions, and voice recordings of trip participants may be taken during various activities for the purpose of illustrations, publications, and websites. I hereby authorize and give full consent to Lolek, LLC to publish and copyright all photographs, videos, written extractions, and voice recordings in which myself while enrolled as a participant in the pilgrimage.

By typing my name below, I give my consent to the above media release.

Student Electronic Signature

(Type your full name.)

Parent Electronic Signature

(Type your full name.)

Step 3: Pilgrimage Paperwork

After your registration is confirmed and the deposit payment of $1500 is received by Lolek, the final step in your registration process is the signing of several forms that require a legal signature. The forms will be completed online using DocuSign; please check your email in the next couple weeks for a link from Jacqueline that will allow you to sign the forms. If you are a minor traveling with Lolek you will be required to print and notarize a Consent to Travel Form.

Again, there is limited space available on this trip. If you are chosen to participate, you will receive a notification from Jacqueline and a link to pay online or via check. If you have any questions, contact her at necatholic2024@lolekpilgrimage.com.

You will receive an email within a few days confirming your spot on the pilgrimage or on the waitlist. You will finalize your registration by paying the deposit of $1500 (due within 7 days of acceptance on the pilgrimage).

Nebraska High School Pilgrimage Registration

June 9-19, 2024

Step 1: Passport and Registration Form

Step 2: Emergency Info & Media Release

Step 3: Pilgrimage Paperwork

You will receive an email within a few days confirming your spot on the pilgrimage or on the waitlist. You will finalize your registration by paying the deposit of $1500 (due within 7 days of acceptance on the pilgrimage).

Lolek PilgrimageWahoo, NE

Lolek Pilgrimage
Wahoo, NE