Word for the World

April 15 - 24, 2015

Remarks; The cost of this tour is $3,495 per person on a double sharing basis, to register, complete this form in its entirety

and include a deposit of $285. Note that registration is not complete until a min deposit of $285 has been made.

Personal Information (as appears on passport):

Last Name: ________________________First Name: __________________________________

Address: ___________________________________________________________________________________

City: _____________________ State: ________ Zip: ____________ Country: ___________________

Phone: _____________________ Email: _______________________________________

Passport Info:

Nationality: __________________________Passport No:__________________________________

Issue Date: _______________Expiration Date: __________________DOB: ___________________

Name Badge:

Name (print clearly): _______________________________________________________________

Emergency Contact Info:

Relation to me: _______________________________________________________________

Emergency Contact Name: __________________________________________________________

Emergency Contact Number: __________________________________________________________

Room Arrangement:

â–¡ Double Room, I will be sharing a room with __________________________________________

â–¡ Double Room, please assign a roommate to me

â–¡ Single room, please provide a single room for an additional fee of $700

Travel Insurance:

â–¡ Yes, please send to me more information regarding travel insurance by email

â–¡ No, please do not offer me insurance

Payment Deadline:

1. $285 deposit by credit card upon registration

2. $1,070 deposit by credit card due by October 7, 2014

3. $1,070 deposit by credit card due by November 7, 2014

4. $1,070 deposit by credit card due by January 7, 2015 (final payment) !

Cancelation/Refund Policy: All cancelations must be done in writing, below please find the refund policy

• For cancelations 91 days prior to the departure date, all deposits will be refunded.

• For cancelations 45 -90 days prior to departure date – all deposits will be refunded, minus $1,700.

• In the case of cancellation less than 44 days prior to arrival - no refund.

Terms and Conditions:

Full and final payment due by January 7, 2015. We reserve the right to cancel this trip due to lack of subscription.

Such a decision will be made no later than January 1, 2015. In the event of cancellation of the trip in its entirety, a refund

of all deposits will be made to passengers enrolled at the time of cancellation. Extensions are usually available but must

be requested when booking the tour. Travel Insurance, is not mandatory, however, it is recommended.

I have read and agree to the terms and conditions. Please sign me up for the trip!

Signature: ________________________________________ Date: ___________________

Send to Pastor Rich; 303 Oakshade Rd., Shamong, NJ 08088; Make check payable to Word for the World; 609-367-6652