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* 1. You must have a passport that does not expire before 5 Sept 2024.  If you are extending your stay, your passport cannot expire before 3 months past your final day of travel in Europe.  (The US State Department suggests 6 months.)  In order for your registration to be complete, you need to send a scan or closeup digital photo of your passport (open to the page with your photo and personal data, with all information legible) to MMaher@SaintChristopherJourneys.com.  If you do not have a passport, you need to send a scan of your passport application.  This is used to purchase your air ticket, which must match your passport exactly.  If you have a non-US passport, you also need to send a scan or closeup digital photo of your green card or US visa.

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* 2. If you are not a US citizen, even if you have permanent residency (a green card), you must visit the following site to determine if you need a visa to travel to Italy.  https://vistoperitalia.esteri.it/home/en

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* 3. In order for your registration to be complete, you need to send a closeup digital photo of yourself (that really looks like you) to MMaher@SaintChristopherJourneys.com.  This is only used in case of an emergency.  Please do not worry about having a "great picture."  Just a recent, accurate photo is fine (a selphie snapshot from a phone for example). 

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* 4. The fee for this journey is $6,650.00.  That includes single-room accommodations.  If you are sharing a room with another participant, the fee is reduced by $400/person.

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* 5. The fee for this journey is $6,650.00.  That includes a $335.00 donation (5%) toward scholarships for students to study at the Volterre center.  Would you like to add on an additional $350.00, making that a 10% donation?

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* 6. The fee for this journey is $6,650.00.  That includes roundtrip airfare from Detroit (DTW) to Florence (FLR), budgeted at $1,700.  While we have not selected an airline yet, Delta is likely.  This is budgeted at the lowest fare, which has many limitations.  Would you like to pay for an upgrade if available?

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* 7. The fee for this journey is $6,650.00.  That includes roundtrip airfare from Detroit (DTW) to Florence (FLR), budgeted at $1,700.  Would you like to extend your time in Italy, or go earlier than the group?  Do you need to depart from or return to a city other than Detroit?  Do you need to fly in or out of a different city in Europe?  We can make these arrangements for you, but you will be responsible for any increase in airfare above $1,700.00.  Do you wish to make a modification to your air plan?

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* 8. Please carefully read the "Waiver and Release" available on the "forms" page at SaintChristopherJourneys.com.  Do you agree with the waiver and release? https://saintchristopherjourneys.com/forms.html

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* 9. Please carefully read the "Code of Conduct" available on the "forms" page at SaintChristopherJourneys.com.  Do you agree with the Code of Conduct?https://saintchristopherjourneys.com/forms.html

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* 10. Please carefully read the "Crisis Management Plan" available on the "forms" page at SaintChristopherJourneys.com.  https://saintchristopherjourneys.com/forms.html

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* 11. I understand that all payments are non-refundable and non-transferable.  I also understand that the final fee for the journey may increase due to unexpected increases in airfare, housing, other travel services, and changes in currency exchange rates.  If not enough participants have been recruited for the journey by the initial deadline and the journey is canceled, I will be reimbursed my payments.  

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* 12. I understand that “Tagging along” is prohibited.  The host organization may (or may not) allow family and friends to join on a journey, but it is required that they are participants and make their arrangements through Saint Christopher Journeys.  Simply “showing up” and then expecting to partake in activities is really unfair to the paying participants.

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* 13. First Name:

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* 14. Last Name:

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* 15. Date of Birth

Date

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* 17. Your Cell Phone Number

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* 18. Your mailing address, including zip code:

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* 19. The name of your health insurance company (If you do not have health insurance, just write “none.” Travel insurance may provide some limited health coverage.)

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* 20. Phone number of your health insurance company (If you do not have health insurance, just write "N/A")

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* 21. Your health insurance policy number (If you do not have health insurance, just write "N/A")

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* 22. Your health insurance group number, if applicable:

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* 23. Name of the primary insured person on your health insurance (if you do not have health insurance, just write "N/A")

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* 24. We are collecting medical information from you.  It is completely optional for you to share this information.  If you have a serious medical condition, we encourage you to wear jewelry that indicates your condition and needs.  We compile this information and provide it to your group leader and with the University of Detroit Mercy.  While we handle your information carefully, our handling does not meet HIPAA standards for confidentiality.  Again, this is optional.  Do you have any medical conditions that would be important to know in case of an emergency, and that you would like to share with us?

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* 25. We are collecting medical information from you.  It is completely optional for you to share this information.  If you have a serious medical condition, we encourage you to wear jewelry that indicates your condition and needs.  We compile this information and provide it to your group leader and with the university of Detroit Mercy.  While we handle your information carefully, our handling does not meet HIPAA standards for confidentiality.  Again, this is optional.  If you would like, please share a list of medications you anticipate that you will be taking while on your journey.

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* 26. Do you have any special dietary needs?

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* 27. Do you have any special needs that would be helpful to know in planning your travel?

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* 28. Name of a person not traveling with you who we should contact in case of an emergency:

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* 30. Phone number of the person to contact in case of an emergency:

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* 31. If you would like to provide a second emergency contact (of a person not traveling with you), please provide their name, email address, and phone number.

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* 32. As part of your signing and consent, please provide today's date

Date

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* 33. Signature: Please type out your full name as a form of electronic signature:

T