REGISTRATION FORM: Israel Study Trip Sept 7 -22, 2012
Personal Information:
Name (as it appears on passport)____________________________________________
Address ____________________________________City_____________ Zip_________
Ph_____________ Cell_____________ E-Mail__________________________________
Attach a clear, readable copy of the face page of your passport to this application
Expiration date on Passport___________________
Contact Information:
Name____________________________________ Relationship____________________
Address________________________________ Preferred Ph.______________________
e-mail________________________________________________________________
About this Trip:
The trip demands a level of physical well being. There will be a good bit of walking, walking on rough, hilly and uneven terrain.
If you have any concerns about this, please feel free to discuss this with us before making a commitment. Some alterations can be made to the daily schedule if necessary but these need to be known by us before the trip so we are aware.
Traveling with a group requires each person to be aware of any personal needs that might jeopardize or impact the movement of the group on the trip. Again, if this is made known to us, we can advise you and make plans accordingly.
Medical Issues:
If you are under the care of a doctor, you should discuss this trip with him/her. Specific conditions may call for immunizations. Generally, shots are not required for travel to Israel. Your health care professional, who knows your condition, can best advise you.
We do not require medical clearance. It is advisable for you to have this for yourself!
Room-mate: (Check what is applicable)
My Room-mate is____________________________________________
I do not have a room mate but would like to share a room with another traveler________.
I understand if this is not possible, I will be responsible for the single supplement of $750.00 ______________
I prefer to have single accommodations__________________________________
Include pages 1 and 2 of this registration form and a copy of your passport face page with your deposit. Your signature is required.
Make checks payable to:
“Catholic Biblical School”
Send to:
P.O. Box 639
Buffalo, NY 14217
By signing this application, you agree and acknowledge that the Catholic Biblical School, Inc, and its agents and employees shall not be responsible for any personal injuries, loss of property, damage caused by others or for any other consequential damages resulting from political or social unrest or the acts of omissions of any other persons or entities providing services during the tour. The itinerary may be changed at the discretion of the office of the Catholic Biblical School. I have read the refund policy and understand these terms.
Name ____________________________________ Date________________
(A copy of pages 1 and 2 will be returned to you for confirmation and reference)
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For Office Use:
1st Payment of $1765 due Jan 9 , 2012 Check No. __________ Date ________
2nd Payment of $2000 due June 1, 2012 Check No. __________ Date ________
3rd Payment of $1000 due July 15, 2012 Check No. __________ Date ________
Single supplement ($750.00) due w/ 3rd payment Check No. __________ Date ________