Art in Havana with Marilyn Zeitlin, November 9 - 15, 2018
To reserve a place on this trip, please complete and submit this online form (for multiple travelers, please complete this registration form separately for each participant). Then mail your deposit of $500 (of which $200 is non-refundable for administrative fees) per person payable to Project Por Amor by June 1, 2018 (if you prefer to pay by credit card (with an additional 3% fee) please contact Sage Lewis at 310-961-1574 or projectporamor@gmail.com).

Mail your check to: Project Por Amor, 4117 Shelburn Court, Los Angeles, CA 90065

PLEASE NOTE: Participants will be traveling to Cuba under a General license as defined by the Department of the Treasury’s Office of Foreign Assets Control (OFAC). These regulations, as of March 2016, require that program participants a) participate fully in all program activities; and b) abide by the terms of the U.S. Embargo. Participants will receive a full explanation of these requirements upon registration.

Email address *
Full Name (as it appears on your passport): *
Your answer
Address *
Your answer
Phone Number: *
Your answer
Birth date:
MM
/
DD
/
YYYY
I prefer to stay in a: *
I would like to share my room with:
Your answer
I have specific needs for flight or accommodations, health conditions, or dietary restrictions that you should know about:
Your answer
Please provide us with the name and phone number of an emergency contact while you are in Cuba:
Your answer
Each participant must understand and agree to the following two statements. *
Required
After submitting this form, you will receive an email from Project Por Amor with your affidavit, government licensing documents, and other necessary paperwork required to travel to Cuba. If any questions arise, please call Sage Lewis at 310-961-1574 or email projectporamor@gmail.com.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms