Prayer Experience: Reservation Application 206 Tours

Please fully complete the following application in order to register for one of our many wonderful trips. You must complete complete this form, print it and mail it to Prayer Experience.

Reservation Made By

TOUR INFORMATION

Tour # (if applicable)

Prayer Experience Pilgrimage to Medjugorje

Departure Date

PASSENGER INFORMATION (Names MUST Be Exact Match to Your Passport)

Title

Name(s) of passengers (Last / First , Middle) DOB (mm/dd/yy) Nickname

1.

2.

3.

4.

Address

Address 2

City, State, Zip Code

Country

Home Phone

Work/Cell Phone

Fax

E-Mail

US Passport #

Exp. Date

EMERGENCY CONTACT

Name

Phone

REGISTRATION OPTIONS

Land Only *

I am registering for Land Only * (arrival/departure transfers not included)

Departure City

Accommodations

Roommate Request

Travel Insurance

I DECLINE Travel Insurance

Travel Insurance will automatically be billed unless you decline coverage at the time of registering. ($129 premium amount based on total trip costs)

SPECIAL REQUESTS

Seat Request

Meal Request

Wheelchair Request

Other Needs

::: ADDITIONAL COMMENTS OR INFORMATION :::

PAYMENT INFORMATION

A $529 per person deposit + insurance is due at the time of booking.

You may send a deposit Only * payment of $400 if you have declined insurance.

Payment in full is required at the time of booking if registering with in 60 days of departure.

A $50 late booking fee is applied for bookings made with in 30 days of departure.

I wish to make my payment via Check or Money Order. I will send my payment by mail.

If paying by check, please make check payable to: 206 Tours

Mail Registration and check to:

Prayer Experience ~ P.O. Box 2089 ~ Peabody, MA 01960

Enrollment in and/or payment for any 206 Tours trip or service constitutes

your unconditional acceptance of all applicable Terms & Conditions.

______________________________________________________

Signature