Israel Experience Tour January 29 - February 08, 2018 PARTICIPANT TOUR APPLICATION FORM

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3 International Christian Embassy Jerusalem US Office PO Box Murfreesboro, TN Phone ; Israel Experience Tour January 29 - February 08, 2018 PARTICIPANT TOUR APPLICATION FORM Check ONE box: I have a valid passport good until August 22, 2018, and my information is below. I have included a color copy/scan of the photo page. My passport expires before August 22, 2018 and I am in the process of renewing. I have included a color copy/scan of my current passport which is being renewed. I do not have a passport and am applying for one. Below is my name and date of birth. When my passport is issued, I will immediately send a color copy/scan of the photo page. PASSPORT INFORMATION: Your passport must be valid for more than six months from the date you return (Aug 22, 2018). Name exactly as it appears on Passport Date of Birth (MMM/DD/YYYY) (e.g. MAR 04, 1980) Date Issued (MMM/DD/YYYY) (e.g. JAN 02, 2010) Place of Birth (from passport) Passport Number Citizenship (from passport) Date Expires (MMM/DD/YYYY) Gender Male Female CONTACT INFORMATION: Please provide us your mailing address so we can mail items to you. Please also circle the best way to contact you whether it is by or by phone. Preferred Full Name Street Address City, State, Zip Cell Phone Other Phone CHURCH OR MINISTRY CONTACT INFORMATION: Name of Church/Ministry & Location Position, if any: Have you been to Israel previously? Yes or No TOUR & PRICING: Land price is based on double occupancy. Please include with your completed application a $500 deposit per person payable to The Rock Church, th Avenue, Scottsbluff, NE (This will secure your place on the trip as space is very limited). All additional payments should be sent direct to ICEJ-USA, PO Box , Murfreesboro, Tennessee An additional deposit of $1,000 is due on or before September 15, Full payment must be received on or before November 15, Page 1

4 Full Name: Price includes: Roundtrip airfare on United Airlines from Denver International Airport (DEN) 8 nights in Israel per itinerary Full Israeli buffet breakfast and dinner daily English speaking, full-time Israeli guide and bus driver with air conditioned tour bus Wi-Fi is typically available at all hotels and tour bus All entrance fees and special sites per itinerary Price does not include: Domestic travel or flight if required to and from Denver International Airport Travel Insurance (Travel medical insurance is required & travel and trip interruption insurance is optional) Lunches if desired typically $8-$12 per day depending on location Tips and gratuities total of $175 per person in cash Israel Experience Tour (Check at least TWO boxes): I will be traveling with you. I have read and understand the terms & conditions and have included my $500 deposit. I would like a single room if available. I understand a single room is available on a very limited basis and there is an additional cost of $550. I would like to share a room with as my roommate(s). I would like to have a roommate(s) assigned if there is another person who is requesting a roommate. I understand if a roommate is not available I will be responsible for the single room or double room supplement additional cost. Domestic airline tickets: Participants are responsible for their travel to and from the international departure/arrival airport and understand international flight times can change. The international flight details will be sent to you by once your application and deposit are processed. If your domestic travel is booked more than 60 days in advance of departure date you are encouraged to purchase a flexible ticket which allows for no charge or minimal charge for flight changes. You will need to arrive at the airport 3 hours before international departure time. Once your connecting domestic ticket is secured (if needed) please your connecting airline, roundtrip flight numbers and confirmation number so we can coordinate your arrival and departure. I plan to drive to the departure (Denver) airport. From whom or where did you hear about this tour? Do you have a previous connection to the ICEJ? (i.e. donor, volunteer, receive newsletters, etc.) EMERGENCY CONTACT: Please provide us with a person we can contact in case of an emergency while you are in Israel. Name Relationship Daytime Phone Evening Phone Please indicate any medically diagnosed conditions or special needs: You should be aware that some days the tour will include a good deal of walking and many times on hilly, uneven or unimproved terrain. Are there any conditions that would impede your ability to keep up with the group? Travel Insurance: Proof of international travel emergency/health insurance is required. Trip cancellation insurance is an optional expense, but highly recommended. Most US healthcare insurance companies will extend health coverage for your overseas travel. You will need to verify from your current healthcare insurance provider if in fact you are covered while in Israel. International travel emergency/health insurance, as well as trip cancellation insurance (if desired), can be purchased online with a wide variety of companies. Many of our previous travelers have been happy with Seven Corners Travel Insurance. You can contact Seven Corners Travel Insurance and shop different coverages at You can also visit to compare a wide variety of different companies and different levels and packages of coverage. I have read and understand the Terms and Conditions as detailed on Page 3: - Initials Date Page 2

5 TERMS AND CONDITIONS Deposit: A US $500 deposit is required for your application to be considered complete, please be aware there are a limited number of airline seats & hotel rooms reserved and your completed application with deposit secure your space. Tour Price (January 29 to February 8, 2018): All prices are per person based on two people sharing a room with a private bath. Single rooms are subject to availability with an additional charge. All tour prices shown are subject to a minimum of 38 participants traveling together. If we have fewer than 38 participants, we reserve the right to adjust the price. Once our airline space is filled we cannot guarantee this price. Foreign Currency Exchange: Some of your tour costs may be based on foreign currency exchange rates and in the event of significant fluctuations could affect the final pricing. International Flights for Tour (January 29 to February 8, 2018): The tour is based on a round-trip airfare from DEN on United Air Lines. Taxes and airline fuel surcharges have been included in your price. Occasionally airlines will charge extra for fuel surcharges. If that happens we will advise you and if the change is substantial add the increase to the price of the tour. Our group airline price is not guaranteed until the day we ticket. Payment Schedule: A US $500 deposit is needed to complete your application. Both airline seats and hotel space are limited as Israel is one of the number one destinations for travel in the world. Your completed application and deposit secures your place on the trip. Additional US $1,000 is due by September 15, Final payment is due by November 15, You may at any time pay the full amount of your trip prior to scheduled date. Deviations: Airline tickets are group priced eleven months prior to departure. ANY group airline ticket change will incur a minimum deviation fee of US $150 plus or minus the cost of the ticketing change. Cancellations: Cancellations received are subject to any cancellation requirements of the airlines plus costs paid by tour operator which cannot be recovered from hotels and foreign agencies. From deposit until September 14, 2017 US $250 cancellation penalty From September 30 to November 30, 2017 US $750 cancellation penalty From December 1 to January 1, 2018 US $1,750 cancellation penalty* After January 2, 2018, no refunds unless special circumstances or arrangements have been made *Plus any other charge we may receive or cannot recover. Registration: To register please make initial $500 deposit check payable to The Rock Church. Send this completed application form and a copy of the photo page of your passport with your payment to The Rock Church, th Avenue, Scottsbluff, NE All additional payments mail to ICEJ-USA Tours, PO Box , Murfreesboro, TN Major credit cards are accepted for an additional 3% fee which is cost to the ICEJ Ministry. Upon receipt of your deposit and completed application, additional information will be sent to you. Passports: A copy of your passport will be required with your application and deposit. If you do not have a passport, please let us know you are in the process of obtaining one. By Israeli law, your passport must be valid until 6 months after the day you return from Israel. (August 22, 2018) If your passport is not valid for more than 6 months from the date you return you will not be allowed to board the aircraft. Sightseeing: This is subject to local conditions at the time of the tour. Adjustments in the program may be made as the tour leader deems necessary for the safety and benefit of the group. Physical Requirements: There may be limitations and restrictions imposed by the travel suppliers (air carrier, tour operator, etc.). Activities on tour require you to be in good health and able to climb stairs and ascending grades without assistance, walk at a modest pace for 3+ miles per day on uneven terrain, and, be able to transport your own luggage when necessary. Participants should be able to participate in all aspects of the tour and travel at the pace of the group. Tips: Tips to bus drivers, guides, hotel staff, restaurants and select site have not been included in the pricing. Travel Insurance: Traveler s Medical Insurance is required and Trip Cancellation Insurance is highly recommended. Please check your medical insurance policy to see if you are already covered. Responsibilities: SAR-EL Tours and the ICEJ-USA act only in the capacity of agent for the passengers in all matters pertaining to hotel accommodations, sight-seeing, tour and transportation, by air, motor-coach, or other means and, as such, hold themselves free of responsibility for any damage(s) from any cause(s) whatsoever. The tour operators will not be responsible for any damage, expense or inconvenience caused by late flight departures, mechanical failures, government actions or by any change of schedules or other conditions; nor will they be responsible for the loss of, or damage to baggage or any article belonging to any passenger. The right is also reserved to decline or accept or retain any person traveling under our auspices. The carriers concerned are not to be held responsible for any act, omission or event during the time passengers are not on board their plane or conveyance. The passenger contract used by the carriers concerned, when issued, will constitute the sole contract between carriers and the purchasers of this tour or its passengers. Image & Sound Release: Registration for tour grants permission for all persons on your reservation to be photographed, audio recorded and or video recorded and releases ICEJ-USA from liability, restrictions, conditions or compensation of any kind for obtaining and using these images and sounds in future promotional materials. Page 3