africa reg

Registration for Sacred Africa

January 25 – February 5, 2019

Please submit a separate form for each traveler

After you complete and submit this form, you will automatically be re-directed to the Payment Page, with instructions on how to pay by check, money order, credit or debit card. A non-refundable deposit of $500 ($525 credit card) is required to reserve your space on this tour.

Africa

Name (as on Passport) *

The name you enter above must be exactly as it appears or will appear on your passport.

Email *

Phone *

Date of Birth (Month/Day/Year) *

Country of Birth *

Mailing Address *

Number & Street

City *

State or Province *

ZIP/Postal Code *

Country

If not USA

Passport Country of Issue *

Passport Number

If you do not have a passport at this time, please submit this form now and provide BMSJ with your passport information after you receive your passport.

Passport Issue Date

Passport Expiration Date

Your passport expiry date should be more than six months after the ending date of this tour.

I am *

Female

Male

I am requesting: *

Double accommodation

Single accommodation (limited availability)

(Optional) My roommate will be:

Body Mind Spirit Journeys will try to match you with a suitable roommate if left blank and Double accommodation selected.

Optional Message

If you require a special diet or have physical limitations that require special attention, please describe here. (Most situations can be accommodated, but we must know beforehand in order to make arrangements, and there may be additional costs.)

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Body Mind Spirit Journeys highly recommends the purchase of Trip Cancellation Insurance, and our preferred Insurance provider is Allianz.