Register for the RVCD Pilgrimage to Lourdes from June 06-11, 2010 206 Tours

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Please fully complete the following application in order to register for the Rockville Centre Diocese Pilgrimage to Lourdes.

You may also complete this form (click here for a printable version) and mail or fax (631-361-3682) it to our office.

Reservation Made By

TOUR INFORMATION

Group Name

Rockville Centre Dioceses Pilgrimage for Priests to Lourdes with Bishop William Murphy

June 06-11, 2010 for $2,199 per person in double occupancy

Optional Tours

I will also join the Pre-Tour to Fatima from June 03-07, 2010 for $696 additional

I will also join the Pre-Tour to Fatima from June 11-14, 2010 for $1,099 additional

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

Title	First Name	Middle Name/Initial	Last Name	Suffix

DOB (mm/dd/yy)	Passport #	Exp. Date	Name for Nametag	Date of Ordination

CONTACT INFORMATION

Church

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

Travel Insurance will automatically be billed ($149 -$229 premium amount determined by total trip costs) unless you decline coverage

at the time of registering as per www.206tours.com/insurance. Initial here to decline Travel Insurance --->

If you Purchase the Travelers Insurance, you may also choose to add the following optional additional Insurance coverage...

Cancel for Any Reason Protection Plan

I want to purchase the Cancel for Any Reason Protection Plan @$199 additional as per

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

SPECIAL REQUESTS

Seat Request

Meal Request

Wheelchair Request

Other Needs

Additional Comments or Information

PAYMENT INFORMATION

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.

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
Name on Credit Card Type of Card

Card Number Exp. Date (mm/yy) CID Code

Payment Option:

I wish to pay For My Trip With PayPal click here (www.206tours.com/paypal)

I wish to make my payment via Check or Money Order. Please send payments to: 206 Tours, 333 Marcus Blvd, Hauppauge, NY 11788

OTHER OPTIONS

Optional, Go Green with paperless invoices and final documents! (information will be sent via e-mail)

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You may also complete this form (click here for a printable version) and mail or fax (631-361-3682) it to our office.

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Milanka Lachman of 206 TOURS, INC. 333 Marcus Blvd, Hauppauge, N.Y. 11788
Phone: (631) 361-4644 | Toll-Free: 1-800-206-TOUR (8687) | Fax: 1-631-361-3682 milanka@206tours.com

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