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2020 Family Trip to the National March for Life - Hosted by Right to Life of Northeast Indiana
This trip is open to the general public. High School students may go on the Life Defenders Bus Trip (
www.ichooselife.org/dc
).
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Participant First Name
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Participant Last Name
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Street Address
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City, State Zip
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Cell Phone # (This number will be used to communicate with you while in DC)
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Email Address
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Date of Birth
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Sex
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Hoodie Size (Adult Sizes)
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L
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Home Church
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Emergency Contact Name & Phone Number
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Physician Name & Phone Number
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Medical Insurance Provider & Policy Number
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Allergies
Lactose Intolerant
Tree Nuts
Gluten
Seasonal/Hay Fever
Cats/Dogs etc
Other:
Dietary Restrictions
Vegetarian
Vegan
Gluten-free
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Other:
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Medications
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Photo Release - allows Allen County Right to Life to use photos taken on the trip to be used for marketing.
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