Hadassah Milestone Mission 2018 Registration Form

Transcription

1 Hadassah Milestone Mission 2018 Registration Form October 7 15, 2018 (Fly from the US on October 7, land in Israel Oct.8) Kindly complete one registration form for each person traveling. Please refer to for more information on this amazing Mission! HOTEL/MISSION OPTIONS Please select your preferred hotel category (Costs listed are for full land tour): Super Deluxe : David Intercontinental Tel Aviv (Executive Room) / David Citadel Jerusalem $3,670 Double room per person (Add $1,500 For Single Room) Deluxe (Main Hotels): David Intercontinental Tel Aviv / Inbal Jerusalem $3,435 Double room per person (Add $1,265 For Single Room) First Class: Dan Panorama Tel Aviv / Dan Panorama Jerusalem $3,225 Double room per person (Add $1,090 For Single Room) Subsidized Early Bird Rate for the first 70 registrants: Save $935 Early Bird Rate - Limited number of registrations available at this rate: Save $535 SPECIAL NURSES TRACK: Please sign me up for the special NURSES TRACK (Thurs. & Fri., Oct 11 12, 2018) LAND SERVICE/HOTEL REQUESTS: (Please refer to for more information on associated costs for particular Missions) Room Type: Single Double/Two in a room Roommate Name(if sharing): Please contact me regarding these possible additional hotel nights or deviations (May incur additional charges.): Dietary Restrictions during the tour: Please contact me about hotel room type upgrade options.

2 PARTICIPANT INFORMATION: First Name: Middle Name: Last Name: Nickname for Badge: Mr. Mrs. Ms. Dr. Male Female Mailing Address: City: State: Zip: Phone: Home ( ) Work ( ) Fax: ( ) Mobile/Cell (USA): ( ) Mobile/Cell (Israel): ( ) Passport Number: Citizen of (Country): Date of Birth (mm/dd/yyyy): Exp. Date (mm/dd/yyyy): Date of Issue: PLEASE CHECK YOUR PASSPORT S EXPIRATION DATE. US Government regulations state that you may not be permitted to depart the USA if your passport expires within six (6) months of your travel dates! CAMPUS CAMPAIGN BUILDERS OF PROMISE CELEBRATION: OCT 5 8, 2018 All donors who have given or pledged a minimum new gift of $25,000 and above to the campus campaign are eligible to attend. Join this incredible pre-tour celebration, as well join together for Shabbat in Israel. We'll explore Tel Aviv's Art Scene, enjoy a VIP experience abroad the new High Speed Rail connecting Tel Aviv and Jerusalem, meet with dignitaries, and go behind the scenes with Israel's High Tech leaders. Includes 3 Nights David Intercontinental EXECUTIVE rooms. $1,780/person (double occupancy), $2,540/person (single occupancy) Rates listed are INCLUSIVE of Pre-Collected Tips of $80/person Yes! I will attend the Campus Campaign Builders of Promise Pre-Tour

3 JOIN US ON A FABULOUS OPTIONAL EXTENSION: Extension Rates Include Tips. Double Rates are per person. Limited Space. Exploring Boundaries - $1,910/person (double occ.), $2,470 (single occ.) Oct , 2018 Includes 4 nights plus guarantee late check out at the Inbal Jerusalem. Rates listed are INCLUSIVE of Pre-Collected Tips of $80/person. Hear from leading thinkers and scholars and gain insight into the current political situation in Israel and the broader Middle East. Among others, we'll meet Col Miri Eisen, former international media advisor to the Prime Minister of Israel, Rabbi Michael Melchior former Knesset member, and Avi Issacharov, Palestinian Affairs journalist. We'll explore Geopolitical dimensions and see facts on the ground that will be crucial to any long term solution to the region's conflicts. Majestic Negev & Start-Up Nation - $1,665/person (double occ.) or $2,295 (single occ.) Oct , 2018 Includes Full night instead of Late Check Out Jerusalem, 2 Nights Beresheet Resort Mitzpe Ramon, and 1 night plus guaranteed late night check out David Intercontinental Tel Aviv. Rates listed are INCLUSIVE of Pre-Collected Tips of $80/person. Explore the beautiful Negev desert region, including time to relax at the breathtakingly beautiful Beresheet Resort and Spa. We'll meet with Bedouins, see the desert bloom in the Frontier region of Eshkol, and marvel at the landscape during our sunrise Jeep tour into the Ramon Crater. Then we'll uncover the secrets of Israel's innovation in Tel Aviv, including a visit to one of the most cutting edge recycling centers in the world, and meeting with a young Israeli Entrepreneur in Tel Aviv. Food, Wine & Design - $2,010 /person (double occ.) or $2,490 (single occ.) Oct 15 18, 2018 Includes Full night instead of Late Check Out in Jerusalem, 2 Nights Mitzpe Hayamim Resort and Spa Rosh Pina, and 1 night plus guaranteed late night check out at the David Inter, Tel Aviv. Rates listed are INCLUSIVE of Pre-Collected Tips of $80/person. Spice factories, herb gardens and chocolate making. Druze hospitality, chef restaurants and ancient bakeries. Together we will eat, drink and explore the best of the North and Tel Aviv. Join us for this delicious and filling adventure! Rest & Relaxation in the Beautiful North - $1,120 /person (double occ.), $2,770 (single occ.) Oct 15 18, 2018 Includes Full night instead of Late Check Out in Jerusalem, 3 Nights Carmel Forest Resort. Rates listed are INCLUSIVE of Pre-Collected Tips of $20/person for the 1 day of included touring in Tel Aviv. Time to unwind. After our amazing week together, let s take in the beauty of the north, get centered and enjoy some peaceful relaxation at one of Israel s most exclusive and most beautiful resorts. Discovering Eilat & Petra- $1,429/person (double occ.) or $1,829 (single occ.) Oct , 2018 Includes Full night instead of Late Check Out in Jerusalem, 2 Nights Dan Eilat. Rates listed are INCLUSIVE of Pre-Collected Tips of $60/person and Jordan visa cost and processing fee of $69. Petra is an absolute wonder! Together we'll discover this incredible destination in neighboring Jordan. Then we relax and enjoy all Eilat has to offer after our amazing experience together.

4 HADASSAH MEMBERSHIP STATUS: Member of Hadassah: Yes No Region/Chapter/Group/portfolio: Associate Member of Hadassah: Yes No Region/Chapter/Group/portfolio: I am NOT a member of Hadassah (female): All female participants are required to be members of Hadassah. If you are not already a member of Hadassah, please select either of the following Hadassah membership options: Annual Membership: Please send a separate membership check for $36.00 for an annual Hadassah membership. Membership checks should be made payable to Hadassah ; OR Life Membership: Please send a separate membership check for $ for a lifetime Hadassah membership. Membership checks should be made payable to Hadassah. Note that $12.50 of the annual membership dues payment/a portion of the life membership/associate enrollment fee is allocated for a subscription to Hadassah Magazine. In keeping with IRS regulations, membership dues/enrollment fees are not considered to be tax-deductible contributions. MOBILITY: I am physically able to climb stairs both on and off a bus without assistance: Yes No - Please provide details: Special Needs: You are required to advise us of any special medical needs or physical limitations such as walking difficulties, wheelchair assistance, severe allergies, etc.

5 FLIGHT REQUESTS: (Please refer to for more information on flight options for particular Missions) EL AL Frequent Flyer #: Other Frequent Flyer # (if applicable): Special Requests for flights: Note: We will do our best to accommodate you, but regret that we cannot guarantee special requests. Seat requests are noted but cannot be guaranteed. EL AL seats can often be prearranged with an EL AL Frequent Flyer (Matmid) number. Flight Deviations: Date of arrival Date of Departure: Note: Deviations from group flight may incur additional charges. Domestic Travel: (Domestic air/connecting Flights can be arranged by Ayelet Tours) Please call me for connecting flights I will book my flight to the departure gateway. (If taking group air, please do not book domestic flights on your own until you have received confirmation of international flights from Ayelet Tours) I wish to depart from city/airport on (date) and return to city/airport on (date Upgrade Request: Please contact me about a Business Class Upgrade Business Class Upgrade must be paid in full at time of confirmation. Special meals requests on flight (please specify): EMERGENCY CONTACT (EC) INFO: Emergency Contact (EC) Name: EC EC Home Phone: ( ) EC Work Phone: ( ) EC Mobile Phone:( )

6 DEPOSIT PAYMENT: A deposit of $ per person is required. Check Enclosed (Payable to Ayelet Tours) OR Charge to my credit card $.00 Card member s name as it appears on credit card: Card number: CID Number (3 digit code/4 digits on Am Ex): Expiration Date (mm/yyyy): _ I hereby authorize Ayelet to charge the credit card provided above. I understand that my payment by check or charge is necessary in order to reserve airline seats and hotel accommodations. I further recognize that these payments are payments for services (i.e. airfare, hotel, etc.) and are not tax deductible as charitable contributions. Card Holder s Signature: _ Card Type: Discover Master Card Visa American Express Card Billing Address (if different than home address above): Street: City: State: Zip: Full Payment is due August 1, Travel Insurance: We strongly recommend the purchase of comprehensive travel insurance, including trip cancellation and luggage insurance. Please log onto Ayelet Tours website at and click on the Travel Information icon for details. Please keep in mind that the terms of any insurance policy are determined by the insurance carrier and that the insurance carrier makes all determinations regarding the insurance policy s benefits. Hadassah has no control over, and accepts no responsibility for any insurance policy in any way, including but not limited to its terms, scope of coverage, administration, determination of benefits or payment of claims. Not Included: Tips to guide, driver and all staff (may be collected on your invoice or in Israel depending on the tour see tour flyer for details), travel insurance (which is strongly recommended), any items of a personal nature or any items described as not being included for the particular Mission on LUGGAGE: Luggage allowance policies are set by the airlines and may change without prior notice. Please contact your airline(s) for the most current luggage allowance policy.

7 SECURITY: We recommend that you read the current Travel Warning issued by the U. S. Department of State, which may be found at: to obtain current information on the general security environment in Israel, Jerusalem, the West Bank, and the Gaza Strip and to reiterate threats to American citizens and U.S. interests in those locations. Current information on travel and security in Israel may also be obtained from the Department of State by calling within the United States and Canada, or, from overseas, HEALTH: By completing and returning this registration form, I hereby certify that I do not have any mental, physical or other condition of disability that could create a hazard for me or other participants. Mail original registration form (if you are not registering online), original Hadassah Disclaimer and Release** (all participants) and Deposit Check (if paying by check) to: AYELET TOURS 19 AVIATION ROAD ALBANY, NY Need further assistance? Contact Ayelet Tours: * (Fax) * HDMissions@ayelet.com **ALL PARTICIPANTS MUST SIGN HADASSAH S DISCLAIMER AND RELEASE, WHICH WILL BE ED TO YOU BY AYELET TOURS WITH YOUR FINAL PAYMENT INVOICE, ROUGHLY 90 DAYS BEFORE DEPARTURE. THE ORIGINAL SIGNED DISCLAIMER AND RELEASE MUST BE RECEIVED BY AYELET TOURS NO LATER THAN 60 DAYS PRIOR TO DEPARTURE (FAXED OR SCANNED COPIES ARE NOT ACCEPTABLE). TRAVEL DOCUMENTS WILL NOT BE RELEASED UNTIL THE ORIGINAL DISCLAIMER AND RELEASE IS TIMELY RECEIVED. We recommend that you retain copies of your check, the forms and documents.

8 Cancellation penalties are as follows: $250 per person, once booked; $500 per person if cancelled from 90 days prior to departure until August 14, 2018; and 100% penalty if cancelled on or after August 15, Full payment is due by August 1, Hotel space is limited, and will be assigned on a first come, first served basis. After our block fills at a given property, rate may fluctuate and rooms may be confirmed in different room categories based on availability, in consultation with registrant. Requests for cancellation must be made in writing. Each mission is priced as a package and no refund or discount will be made for any part of the mission/activity in which you choose not to participate. In addition, no refunds will be made if you leave the trip voluntarily or involuntarily after the date of departure. Participants may also be subject to any cancellation fees assessed by the purveyors of services, including airlines or hotels. I understand that my reservation will be accepted subject to the above terms and conditions. I have read, understand and agree to the above terms and conditions and understand that this document constitutes an agreement solely between the undersigned participant and Ayelet and that Hadassah is not a party hereto. Participant s Signature: Date: Disclaimer: IGT and Ayelet Tours, Ltd. act only as agents for the tour members in making arrangements for hotels, transportation, touring, restaurants or any other services in connection with the itinerary. We will exercise reasonable care in making such arrangements. However, we do not assume nor bear any responsibility or liability whatsoever for any injury, death, damage, loss, accident, delay or irregularity to person and property because of an act, sickness, or circumstance beyond our control or an act of default of any hotel, airline carrier, restaurant, company, or person rendering any of the services included in the tour. The right is reserved to cancel or change itineraries or to substitute comparable service without notice. The right is reserved to decline to accept or retain any tour participants should such person's health or general comportment impede the operation of the tour or detrimentally affect the other tour participants. (Phone) * (Fax) * HDMissions@ayelet.com *