Name of Group/Parish: *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

Fax *

Person Responsible for Group:

(Person Responsible for Group) Name: *

First

Last

Title

Email *

Phone *

Cell

Contact Person on Day of Visit:

(Contact Person on Day of Visit) Name: *

First

Last

Phone *

Guided Tours are given only on Monday thru Saturday ( 1O AM - 3 PM). No tours are given on Sunday

Date (No tours are given on Sunday.) *

Arrival Time *

Departure Time *

Group denomination: *

Please explain Other

Group language: *

Please explain Other

Group Age *

Number of Persons in group *

Tour of the Shrine (allow at least 1 hour for tour).

Tour of the Shrine (allow at least 1 hour for tour) GROUP WOULD LIKE (please check all that apply): *

There is no charge for tours - Donations are greatly appreciated

Group will attend the daily 11:30 am Mass *

Yes
No

Priest(s) will accompany the group *

Yes
No

Number of Priest(s) in the group *

Group Priest(s) will concelebrate 11:30 am Mass *

Yes
No

Group Priest(s) will celebrate Mass privately for group *

Yes
No

What language *

In English
In Polish
Other

(other languages please bring your own Mass books)

Priest(s) names:

LUNCH IS AVAILABLE IN THE SHRINE CAFETERIA:

PLEASE SELECT MEAL OPTION: *

We wish to pre-order a group lunch
We will bring our own lunch
We will not be eating during our visit

Lunch must be pre-ordered as a group. $12 per person. Please make one payment for whole group (cash, check or credit card accepted). Minimum 25 people, (if less than 25 persons, lunch cost is $ 15 per person). Please add 6% tax to all meals. - Buffet style includes Chefs Choice of 2 main menu items plus additional sides, drinks and dessert. (Menu: fried chicken, roast beef, stuffed cabbage, kiełbasa, pierogi, mashed potatoes, cole sław, babka, fruit, coffee/tea, soda ... )

IMPORTANT INFORMATION

Guided Tours are given only on Monday thru Saturday ( 10 AM - 3 PM). No tours are given on Sunday.
There is Exposition of the Most Blessed Sacrament in Our Lady of Czestochowa Chapel (lower church) after 11:30 AM Mass. Tours are given in the Lower Church only until 11 AM. If you wish to include Our Lady's Lower Chapel, tour MUST begin at 10:00 AM.
Gift Shop is open daily from 9 AM - 4:30 PM.
We reserve the right to change the order or length of the tour based on Shrine Scheduling conflicts.
Cancellations must be received in writing at least 48 hours before arrival.

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CONTACT US

Registration Form for Day Groups Visiting Shrine

IMPORTANT INFORMATION

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