Registration for Fatima, Portugal; August 2-10, 2010

Name: *

(Exactly as it appears on your passport.)

Name: *

(As you would like it to appear on name tag.)

Address: *

City: *

State: *

Zip: *

Country: *

Country in which passport was issued: *

Passport Expiration Date: *

E-mail: *

Home Phone: *

Cell Phone:

Work Phone:

T-Shirt Size: *

Your Age Range: *

Base Cost of Fatima, Portugal Pilgrimage: $2575.00*

City you will be traveling from (Add-on City):

Optional Travel Insurance: $179.00: *

yes

Optional Single Supplement: $549.00: *

yes

Name(s) of traveling companions:

Name of roommate (if applicable):

Do you have any special travel or dietary needs?:

If yes, please explain, or include additional information

*Payment needs to be received in full by June 1, 2010. $500.00 non-refundable deposit is due at the time of your registration.

**Deposits may be made by personal check, Visa, Master Card, or Discover. Additional payments must be made by check or money order.

**In addition to a $200 per person administration fee (applies to all cancellations regardless of the proximity to departure and loss of deposit), the following charges apply if a cancellation is made before departure:

60 - 46 days prior to departure: 10%
45 - 21 days prior to departure: 50%
20 - 03 days prior to departure: 80% 
02 days prior to departure or no-show: no refund