Southshore Expedition Israel - Passenger Information
Please complete all applicable fields. If you are registering for 2 or more individuals, separate forms must be filled out (you will be given opportunity at the end to submit another form)
Welcome to Southshore Bible Church Israel Expedition 2020!
Last name/First & middle name (EXACTLY as it appears on your Passport) *
Your answer
Passport # *
Your answer
Issue Date: *
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YYYY
Expiry Date: *
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Place of Issue: *
Your answer
Date of Birth *
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Home Address (include City/postal code)
Your answer
Home Phone # *
Your answer
Cell Phone # *
Your answer
Email Address *
Your answer
Travel Insurance Needed *
Sharing with (they must fill out a separate Trip Booking Form) (If requesting Single room, please indicate here. Single Supplement $1050): *
Your answer
Do you have any food allergies, mobility issues or special needs that we should be aware of? Please note that all participants should be in good health & be able to walk at a moderate pace. The terrain at some sites is uneven. *
List any food allergies, special needs or mobility issues, if applicable
Your answer
Please list any special requests here (eg bed type, type of seat on aircraft)
Your answer
Name & phone # of emergency contact (someone who is not travelling with you) *
Your answer
What is their relation to you? *
Your answer
I will be paying $800 deposit by: *
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