REGISTRATION FORM Ornit Pilgrimages

By submitting this registration form, I have read and agree to all terms and conditions set forth in the brochure and this form. I understand it is my responsibility to obtain any visas/re-entry permits necessary for this trip if I do not hold a U.S. Passport.

PLEASE ATTACH A COPY OF YOUR PASSPORT TO THIS FORM.

Should you not submit a copy of your passport, any future corrections of any information provided below may result in a change fee by the airlines. You will be responsible for this fee

Destination that interests you (required)

Last Name on Passport (required)

First Name on Passport (required)

Middle Name on Passport (required)

Address (required)

City, State, Zip code (required)

Phone number, with area code (required)

Passport number (required)

Country of issue (required)

Date of issue (required)

Expiration date (required)

Gender (required)
M F 

Birth Date and Country (required)

In case of emergency please contact - name and phone: (required)

Please choose one of the following (required)
 I want to room with (given name) I need a roommate I want a single room (at additional $700.00)

Your Email (required)

Additional Information

A deposit of $500.00 per person- (See terms and conditions)

Please make checks payable to Ornit Pilgrimages LLC.

Please mail checks, registration form and copies of passports to

Ornit Pilgrimages LLC

8930 Wurzbach Rd Suite 140

San Antonio, Texas 78240

© Copyright 2017 by OrnitUSA