Their job is to look after Israel. Ours is to look after them. 1

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1 Please complete this registration form and send to: Elena Zamudio, the FIDF Delegation Liaison, from Mosaic Tours 6345 Collins Ave Miami Beach, Fl or tours.com or Fax: (305) or Tel:(305) Deadline for registration is March 15, Forms received after March 15, will be confirmed according to availability. PLEASE SUBMIT A COPY OF THE PHOTO PAGE OF YOUR PASSPORT WITH THIS APPLICATION PARTICIPANT 1 (exactly as on passport) Name: (Title/First/Middle/Last) Name as you would like it to appear on name tag: Address: (Street/City/State/Zip) Date of Birth: Place of Birth: Passport #*: Date of Issue: Home/Office #: Date of Expiration: Nationality**: Mobile #: Emergency Contact (Name/Relationship/Phone#) Shirt Size:(S/M/L) PARTICIPANT 2 (exactly as on passport) Relationship to above participant Name: (Title/First/Middle/Last) Date of Birth: Name as you would like it to appear on name tag: Place of Birth: Address: (Street/City/State/Zip) Passport #*: Date of Expiration: Date of Issue: Nationality**: Home/Office #: Mobile #: Emergency Contact (Name/Relationship/Phone#) Shirt Size:(S/M/L) 1

2 Poland and Israel *Please note that your passport must be valid for at least 6 months following your return to the U.S. ** Those in possession of Israeli passports are subject to VAT on accommodation. Israeli law requires Israeli passport holders to enter Israel only on their Israeli passport even with dual citizenship. Travel Package is LAND ONLY* *If you are interested in deviating from the basic delegation package (upgrades, extensions, etc.), please contact Elena Zamudio from Mosaic Tours at Tel:(305) or Elena@mosaic tours.com. May 2 10, 2019 $10,000 per person based on double occupancy $2,320 single occupancy supplement Participant Name: Participant Name: *The flight from Poland to Israel will be on an IAF airplane and is included in the cost. Flights*: Arrival to Poland, please indicate the date of arrival, not departure. Date Airline Flight Departure City Departure Time Arrival Time Class *The flight from Poland to Israel will be on an IAF airplane and is included in the cost Departure from Israel to the U.S. Date Airline Flight Departure City Departure Time Arrival Time Class A transfer will be provided to participants arriving in Poland on May 2 nd from the Krakow Airport to the hotel. Rooming Assignments and Upgrades: If you are interested in deviating from the basic delegation package, (upgrades, extensions, etc.), please contact Elena Zamudio from Mosaic Tours at Tel:(305) or Elena@mosaic tours.com. Please note upgrades must be paid at time of booking in order to confirm. Room upgrades are non refundable and are above and beyond the cancellation policy. 2

3 Poland: The delegation is based on Classic rooms at the Sheraton Krakow Hotel. For any upgrade at the Sheraton Hotel, please contact tours.com or Tel:(305) Israel: The Delegation is based on Deluxe New City rooms at the King David hotel. Please indicate if you would like to upgrade your room from the list below: Do you have any personal connection to the Holocaust? We encourage you to find if your family had any connection to these events as, during the delegation, we will have the opportunity to pay homage to the memory of family members that perished. Rooming Assignments and Upgrades: The delegation is based on Classic rooms at the Sheraton Krakow Hotel. For any upgrade / deviation at the Sheraton Hotel, please contact Elena@mosaic tours.com or Tel:(305) Incidentals: To hasten the hotel check out process, we ask permission to give the hotel your credit card number in advance in order to charge any incidentals you might have accrued. Please check the relevant box Y N if you agree to this stipulation. Please note, if you decide not to give your card number, it will be your responsibility to check out the day we leave. Pre Arrival package to Warsaw, Poland April 30 May 2, 2019 Pre Arrival Package April 30 May 2 $2,125* per person based on double occupancy $395 Participant single Name: occupancy supplement Participant Name: *Based on a minimum of 10 participants. Flight information should be filled out in the flights section of your package page above. The Pre Package includes: Meeting and assistance upon arrival at Warsaw airport 3

4 Transfer to the hotel 2 nights including breakfast at the Bristol Hotel in a Superior room Welcome dinner on Tuesday April 30 th and dinner on Wednesday May 1 st Lunch on Wednesday May 1 st Full day sightseeing as detailed on the Itinerary All entrance fees and Service charges Transfer Warsaw Krakow Arrival to the Sheraton Hotel in time for the welcome dinner Package does not include: Lunch on Thursday May 2 nd Alcohol at meals About you: 1. Please provide us with your travel cell number/s: Participant 1: Poland# Israel # Participant 2: Poland# Israel # 2. How did you learn about the delegation? My local chapter FIDF Website/ Other 3. Is this your first time to Poland and/or Israel? N Y If No please share your previous experiences: 4

5 4. Do you have any restriction(s) such as impaired hearing, mobility, vision, etc. that require special arrangements, equipment, or assistance for you to participate in the delegation? N Y If Yes please specify: 5. Please write a short biography about yourself (occupation, interests, affiliations with FIDF and Israel in general and any other information your feel is appropriate). Please feel free to attach a separate page. Participant 1 bio: 5

6 Participant 2 bio: Are you willing to be interviewed by reporters covering the Delegation? Y N Media Release: By signing and submitting this Registration each Delegation participant affirms FIDF to use his or her name and to use photographs and/or sound and image recording of him or her for the marketing and/or promotion of FIDF s cause. I further release FIDF, its agents, employees, officers and directors from any all claims that I may have for any cause of action arising out of the use of his or her name and/or image. Participant 1 signature: Date: Participant 2 signature: Date: PAYMENT* Final payment due by March 15, 2019 Applications received after March 15, will confirmed based on the availability 6

7 Deposit (due with application) $3,000 per person x $ *Please note, Any payment of deviation will be charged directly by the travel agent Deviation can't be paid with American Express. Total $ For credit card info please call the travel agent to provide details For checks please make checks out to Friends of the IDF FEE DOES NOT INCLUDE: Airfare transportation except for flight from Poland to Israel for those participating in both parts of the delegation; airport taxes, customs, and immigration fees; passports & visa fees; travel and baggage insurance; meals not included in the itinerary; after meal beverages ( house wine is included with dinner); personal expenses (laundry, mini bar, valet services, cables, phone calls, postages, etc.). Health, travel and baggage insurance are the responsibility of each participant, and are not included in the delegation costs. CANCELLATION POLICY: Cancellations up to January 31, 2019 incur a $1,500 cancellation fee, per participant. Cancellations between February 1 February 28, 2019 incur a $2,600 cancellation fee, per participant. Cancellations after March 1, 2019 incur a 100% cancellation fee, per participant. Regardless of date of cancellation, room upgrade and extra services are non refundable and are in addition to the standard cancellation. *NOTE: ALL CANCELLATION FEES ARE NON REFUNDABLE. ALL CACELLATION FEES WILL GO TOWARDS PAYING FIDF s COMMITMENTS TIED TO THE DELEGATION. ANY BALANCE OWED TO YOU BEYOND THE CANCELLATION FEE WILL BE REFUNDED TO YOU PER THE CANCELLATION SCHEDULE ABOVE. THERE WILL BE NO REFUNDS FOR UNUSED DELEGATION COMPONENTS OR SERVICES. Itinerary is subject to change based on IDF activities and availability of locations and presenters/hosts. 7

8 The above prices include only those accommodations and activities that are listed in the itinerary. Additional terms conditions and waivers General: The arrangements for the Delegation for which you are registering ( Delegation ), including air and ground transportation, hotel accommodations, restaurants, tours and other features of the Delegation, have been made by Mosaic Tours ( Agent ) as agent for Friends of the IDF ( Sponsor ) which is the sponsor of the Delegation. Agent will exercise reasonable care in making these arrangements, but neither the Agent nor the Sponsor will assume or bear any responsibility or liability for any personal injury, sickness, death, loss or damage to property occurring during the Delegation or due to any other circumstance whatsoever beyond Agent s control, or due to the act or Delegation of any airline, hotel, restaurant or other party supplying goods or services included in the Delegation. Agent and Sponsor reserve the right to cancel or change the itinerary for the Delegation or to substitute features of the Delegation without notice when reasonably required by the circumstances, and to decline to allow or to continue participation in the Delegation by any person whose health, medical condition or general deportment may impede the operation of the Delegation or detrimentally affect the other Delegation participants. Medical Condition: Each Delegation participant acknowledges that any medical treatment that they may require during the course of this Delegation, and any associated expenses, will be his or her sole financial responsibility and not that of Agent or FIDF. Release and Indemnification: By signing and submitting this Registration, each Delegation participant acknowledges that he or she is aware of the risks inherent in overseas travel and has assumed the risks of participating in the Delegation. These risks include, but are not limited to, personal injury, property damage, or death resulting from accident, illness or acts of terrorism. Each Delegation participant has had an opportunity to read the current United States Department of State s Travel Warning for the Delegation destinations and itinerary and has been apprised of the availability of updated Travel Warning information at He or she will abide by security directives issued by Agent, Sponsor or their representatives during the course of the Delegation. He or she understands that any travel outside of the planned itinerary will be at his or her own risk and Agent and Sponsor will not be responsible for his or her safety or security. Each Delegation participant acknowledges that he or she is primarily responsible for his or her own safety and security while on the Delegation. In consideration of being permitted to participate in the Delegation, each Delegation participant does, for himself or herself and for his or her heirs, executors, administrators and assigns, release, discharge, indemnify and hold harmless Agent and Sponsor and their employees, officers, directors, partners, shareholders, agents and contractors, and their successors and assigns, from and against each and every claim arising during or in connection with the Delegation and by reason of any bodily injuries (including emotional injuries), death or property loss or damage resulting, or alleged to result from, any accident, incident, or occurrence, and whether based on negligence, breach of contract or other cause or principle of law, as a result of his or her participation in the Delegation or any activities related or connected thereto. This Registration form, including this release, contains the entire agreement between the parties and supersedes any other understandings, oral or written, concerning the Delegation. If any portion of this release is held to be invalid, it is agreed that the remaining provisions shall continue in full force and effect. Each Delegation participant affirms that he or she has read this document, understands its content, has had an opportunity to consult with his or her counsel, and recognizes it to be a legal, binding and enforceable contract. The signature of each Delegation participant is required. Participant 1 signature: Date: Participant 2 signature: Date: Important information while traveling with FIDF We recommend purchasing the following insurances: Travel, Baggage and Medical insurance. If you have prescription medications, please make sure to bring enough with you for the trip and carry it in your hand luggage. Many forms of medication that are over the counter in the U.S. are not considered over the counter in Poland and Israel, and some U.S. prescriptions will not be honored by pharmacies for anything not over the counter. 8

9 If you have food allergies such as Gluten or nuts or any other allergies, please take necessary precautions since we cannot guarantee that the food we provide does not have these components. Travel to Israel & Poland requires passports that are valid for six months from the date of return to the U.S. Please complete this registration form, and a copy of the photo page of your passport and send to: Elena Zamudio, the FIDF Delegation Liaison, from Mosaic Tours 6345 Collins Ave Miami Beach, Fl 33141, Elena@mosaic tours.com, Fax: (305) , Tel:(305) Deadline for registration is March 15, Forms received after March 15, will be confirmed according to availability. Friends of the Israel Defense Forces is a 501 (c)(3) not for profit organization. Contributions are tax deductible to the extent permitted by law. 9