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BRIDE INFORMATION
Bride's Name:
Address:
City / Prov (State) / Postal Code:	//
Country:
Phone:
Email:
GROOM INFORMATION
Groom's Name:
Address:
City / Prov (State) / Postal Code:	//
Country:
Phone:
Email:
CEREMONY INFORMATION
Place of Ceremony:
Address of Ceremony:
City / Prov / Postal Code:	QC
Ceremony Date:
Time of Ceremony:
PLEASE SELECT BELOW
Individual Price Guide:	Chapel Rental  $250.00    Rehearsal  $100.00    Sand Ceremony  $50.00    Unity Candle   - No Charge    Witness   - No Charge    Special Ceremony Location   - No Charge
Package Price Guide: Please select the package name to the right to see package descriptions.	Traditional Package (A) - $350     Remembrance Package DVD (B) - $425     Picturesque Package CD (C) - $500     Elegance Package DVD/CD (D) - $550     Forevermore Package (E) - $375
Comments/Questions:
Thank You!

We endevour to perform weddings anywhere in Quebec. Due to the high cost of travel, there is a mileage charge of .45 cents per kilometer round trip. EXCEPTION: There is NO MILEAGE CHARGE for Rehearsals and Ceremonies held on the islands of Laval and Montreal. We determine mileage by using Google Maps.We use 34 Cartier Blvd, Laval, QC as our starting point and then input your destination to determine the exact mileage. The formula then is: mileage x2 x.45cents = travel cost. Pastor S. Roach is an ordained Minister and is a registered Officiant with the Province of Quebec. He has been performing Weddings for 29 years. Tel: 1-450-533-9161 Cell: (514) 238-2591 E-mail: sroach@victoryharvest.com DISCLAIMER: If your marriage is for any purpose having to do with facilitating your Immigration to Canada or for seeking entrance to Canada or as leverage to stay in Canada, PLEASE DO NOT FILL OUT THIS FORM. You must meet the required legal criteria otherwise we cannot marry you. Please understand that the information you provide is for your legal Marriage document DEC-50 Declaration of Marriage and must be accurate. It is against the law to enter false information. We offer our services to you as a privilege to you and we will uphold the sanctity of marriage morally, socially, and legally. Birth certicates will be required and produced prior to the ceremony by the couple and witnesses to verify identity and age. Chapel Wedding Services is listed with: Weddings Canada Bridal Network Services A Perfect Match Dream Weavers Canadian Bride The Complete Wedding Directory

Note: This form is for preliminary information only. When this form has been received, we will proceed with the second more detailed form. All information will be used to complete the Marriage Registration Form and Wedding Certificate prior to the Ceremony. It is required by the Province of Quebec that we post Publication of your Marriage at least 20 days prior to the Marriage date. This will be posted at 821 ch. de la Carriere, Brownsburg-Chatham, QC and 361 des Erables, Brownsburg, QC. There is a mileage charge of .45 cents per kilometer round trip for Rehersals and Ceremonies. EXCEPTION: There is NO MILEAGE CHARGE for Rehersals and Ceremonies held on the islands of Laval and Montreal. We determine mileage by using Google Maps. We use 821 ch de la Carriere, Brownsburg-Chatham, Qc. as our starting point and then input your destination to determine the exact mileage. The formula then is: mileage x2 x.45cents = travel cost.