Registration – Mãe Peregrina

Warning: Fields with * (asterisk) are mandatory fields.

Name *

First

Last

E-mail *

Birth Date *

DD-MM-YYYY

Telephone *

Address *

Street, Avenue, Parish, County, District

City *

Postal Code *

ID Card

ID Card Validity

The ID Card must be valid for more than 180 days (06 months) after the pilgrimage departure date.

Passport

The passport number must be sent no later than 60 days prior to departure.

Passport Validity

The passport must be valid for more than 180 days (06 months) after the pilgrimage departure date.

NIF / CPF *

Nationality *

Do you have any health problems? Which?

Do you have any dietary restrictions? Which?

Itinerary *

Italy Special – Institute Hesed Portugal – 11/14/2025

Accommodation *

Double Room
Twin Room
Single Room (Add 40% to package value)

Roommate

If the pax enters the group alone, and subsequently no one who can form a double enters, up to 30 days before the travel we will contact you informing you of the need to pay for the single room

Payment Method *

Accession Fee *

I agree that upon registration I will pay the accession fee of €80 and send the proof to the email grupo.pt@maeperegrina.pt

The rest of the package can be paid in installments as described in the program.

Telephone

Email

Bank Data