REGISTRATION FORM - Gombin Society Trip 2018 Warsaw, Płock & Gąbin Poland
Completing this form and sending your required deposits serves as registration for the August trip to Poland.
Name(s) and ages of participants. Please note relation to each other.
What is the best email and phone number to use to contact you /your group?
Have you confirmed that all members of your party have valid passports?
What are your hotel accommodation needs? The Gombin Society will book the rooms. Participants will be responsible for any incidental hotel charges.
If you are traveling alone, are you interested in sharing a room with an appropriate roommate to save money?
Do you have any special hotel needs? If yes, detail here. (include if you would like to book additional nights in Warsaw before or after the itinerary start.)
Are you / your family current active dues-paying members of the Gombin Society? You must be current to attend.
Have you submitted your deposit? Reservation deposits are due at follows: FIRST DEPOSIT: April 1, 2018 $500 per person and SECOND DEPOSIT: May 15, 2018 additional $500 per person. Payments may be made as follows: By check payable to the Gombin Society and sent to Mindy Prosperi, 185 Skyline Drive, Highland Mills, NY 10930 or if you prefer to pay via credit card please go to our website (
) and chose the DONATE tab. Then choose $500 (or multiply by number of participants you are paying for) and choose to pay via PayPal, or Credit or Debit card. This is a secure link and your data will be safe.
Once you have registered for the trip and submit your deposit(s) you will receive an acknowledgement and receipt at the contact email address given above. If you have any additional questions or concerns, please feel free to contact Mindy Prosperi at
or 845-642-7654. You can also ask a question in the space below.
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