Pilgrimages to Medjugorje with accomodations at visionary Ivan Dragicevic Home

A $400 per person deposit is due at the time of booking. The balance of your trips costs will be due 60 days prior to departure.

Please note a late booking fee of $50 will be added to reservations made with in 30 days of the departure date.

Reservation Made By

TOUR INFORMATION

Group Name	Medj -1
Destination	Medjugorje
Departure Date

PASSENGER(s) INFORMATION (Names MUST Be Exact Match to Your Passport)

Address

Address 2

City

State

Zip Code

Country

Home Phone

Cell Phone

Work Phone

Fax

E-Mail(s)

EMERGENCY CONTACT

Name (first + last)

Relationship

Cell Phone

E-mail

REGISTRATION OPTIONS

Land Only *

I am registering for Land Only (arrival/departure transfers not included)

Departure City

Business Class

Accommodations

Roommate Request

Travel Insurance

I DECLINE Travel Insurance as per www.206tours.com/insurance ($129 -$229 premium amount determined by total trip costs)

Travel Insurance will automatically be billed unless you decline coverage at the time of registering.

Cancel for Any Reason Protection Plan

Yes, I ACCEPT the Cancel for Any Reason Protection Plan @$199 additional as per

www.206tours.com/cancellationprotection (additional $199, must be purchased with the Travel Insurance)

SPECIAL REQUESTS

Seat Request

Meal Request

Wheelchair Request

Other Needs

Additional Comments or Information

PAYMENT INFORMATION

Name(s) of passengers (Last / First , Middle)

DOB (mm/dd/yy)

Passport #

Exp. Date

Nickname

206 VIP Club #

I wish to make my Instant payment from my Checking Account (Automated Clearing House)

Your Bank Routing Number
Your Account Number
Amount

I wish to make a direct credit card payment
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Card Number Exp. Date (mm/yy) CID Code

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OTHER OPTIONS

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