Walking With Purpose 2023 Registration Form

Name*
First Last
Date of Birth
Email*
Phone*
Are you interested in daycare? (available for Wednesday a.m. session only)*
If you are interested in daycare, please list your children's names and ages. Please format your responses as follows: Child Name, Age
Child Name, Age Child Name, Age Child Name, Age Child Name, Age
Please let us know if there any special comments or instructions related to daycare.
Session Selection: Please select which 2023 session you would like to sign up for.*
Additional Comments: Please use this section to let us know about any group requests, personal comments, and details needed pertaining to assigning you to a group, or anything else you'd like us to know, such as requests for financial aid, scholarships, etc..
Form of payment*
- I would like to pay via Faith Direct
- I would like to pay via credit card
- I would like to pay via check
Registration Fee
Price:
Please click the "Make Your Payment" button below to make your registration payment on Faith Direct and then return to this registration form.
Make Your Payment
Checks can be made payable to the Basilica of St. Mary. Payment should be mailed to or dropped off at the Basilica's parish office at 313 Duke Street.

Credit Card

Cardholder Name

Card Details

Child Name, Age	Child Name, Age	Child Name, Age	Child Name, Age