Pilgrimage to Sri Lanka 2019 Registration
You can download a copy of the contract for your records at https://goo.gl/EoCwk6
Full Name (Please write it *exactly* as written in your Passport) *
It is important to give the exact same name that is listed on your passport as this will be the name used on your Sri Lanka visa application.
Your answer
Preferred name (or nickname)
Your answer
Day of birth *
Your answer
Month of birth *
Year of birth *
Your answer
Complete Home Address (please include street address; city; state; ZIP code and country if outside the USA) *
Your answer
Best phone number to reach you *
Just in case we need to get ahold of you more quickly than via email in an emergency only. Please include the country code if outside the USA or Canada.
Your answer
Email address *
Please know that we rely solely on email to keep you updated about trip information.
Your answer
Passport country of issue *
Your answer
Passport number *
Your answer
Expiration date of passport *
Important note: Your passport must have at least six months validity from the end of the trip and at least two blank pages in it. If you wish to register for this trip but have an expired or soon-to-be-expired passport, you can still enter your old passport info and we will update it when you send us the new information.
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Will you have a single room or a shared room on this trip? *
If you are willing to share but don't have a roommate already, we can let you know if others are in a similar situation. However, we can't guarantee that you will have a roommate.
If you are sharing a room, what is your roommate's name?
Your answer
Occupation & Interests: Please tell us more about you so we can make sure you get the most out of your time with us! We can help find little gems along the way that are in line with your interests. *
Your answer
Emergency contact information *
Name; Relationship; Phone Number; Email
Your answer
Food allergies (gluten, dairy, etc) / Dietary restrictions (vegetarian, vegan, etc)
Your answer
Do you have any health conditions and/or severe allergies (food, drug, or environmental) we should be aware of? Do you use any medications you will need refrigerated or medical devices that require electricity?
Your answer
Briefly describe your meditation practice.
Your answer
What are you hoping to experience on this journey? How can we help you get the most out of your time with us? *
Your answer
How did you first learn about this trip? *
Your answer
Please read and sign the Tour Contract and Liability Waiver below.
I agree to the Tour Contract and Liability Waiver *
Required
Please sign below with your digital signature which consists of your full name *
Example: John Q. Sample
Your answer
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