Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress Line 1 *Address Line 2City *State *Zipcode *Email *Phone *Do you give permission to Virginia Pro-Life Day to send you texts regarding the event? *YesNoWould you like to be a District Captain?Yes, and I grant permission for my contact information to be shared with other registrants from my district, as well as my legislators.NoDo you require shuttle transportation to get to your member's office?YesNoAdvocates will walk approximately 1/2 mile to the General Assembly Building from the Convention Center.Do you plan on bringing students or children?YesNoIf yes, how many?Are you a student?YesNoIf a student, what school?How did you hear about this event?Social MediaVirginia Society for Human LifeVirginia Catholic Conference NetworkChurch BulletinDiocesan NewspaperOther (list below)OtherPermissions *By registering for Virginia Pro-Life Day 2025, I give permission for the following:I agree to share my contact information (name and email address) with my District Captain and potentially other members of my district.I agree to have my photo used for promotion of the event. To opt out, I can email info@vaprolifeday.org. Sign me up for future alertsPlease Note: If you are not sure who your representative is, please look under our FAQ’s section on the "Who is my Legislator?" tab. You will be contacted by your district captain once assigned to a team.Submit