Travel to Jordan Registration Form April 15 25, 2019 Please complete all six pages of this registration form and agreement and retain a copy for your records. One form for each individual passenger is necessary. In addition to this completed and signed registration form, please provide a copy of the first page of your passport, which must be valid for at least six months after our scheduled departure to Jordan and contain at least one blank page. Name and Contact Information Legal Full Name (as listed on passport): Preferred Name (what you like to be called): Home Address: (street) Email: (city, state) (zip) Phone: *Nationality: *Passport Number: Passport Issue Date: Passport Expiration Date: Birthdate: Place of Birth: (state/province) (country) *The Jordanian government requires that certain nationalities obtain an entry visa prior to travel. We will submit an application, but it is the traveler s responsibility to confirm that they meet the entry requirements in advance. Accommodations and Pricing Information Double accommodations are only available for travelers who agree to share space with each other in advance. We will not assign roommates to those traveling individually. See Sales Agreement page for pricing details. I d like single accommodations, and my cost for this trip will be $7,500. I d like double accommodations, and my cost for this trip will be $6,500. My roommate will be: 1 of 6
Air Transportation Travelers are responsible for booking and purchasing their own flights to/from Queen Alia International Airport. Direct flights are available from both Chicago and New York City. Health and Emergency Contact Information Please note any medical conditions of which we should be aware: Please note any allergies to medication or food: Please note any dietary restrictions (including vegetarian or vegan): In case of emergency, please notify: (name) (relationship) Primary Telephone: Secondary Telephone: Traveler Biography We ll be sharing notable information about our travelers within the group in order to know each other better ahead of the trip. Please write a brief, 3 4 sentence biography, including your occupation and one or two interests. 2 of 6
Travel to Jordan Sales Agreement Dates April 15 25, 2019 Pricing* Double (per person): $6,500 Single (per person): $7,500 *$1,500 per person will be considered a tax-deductible donation to the Authors Guild Foundation. Included Meet and assist at Queen Alia International Airport upon arrival and departure Ten nights accommodation with daily breakfast at the following five-star hotels: o Four Seasons Hotel Amman o Sun City Camp Wadi Rum o Petra Movenpick Hotel Petra o Jordan Valley Marriott Resort Dead Sea Transportation by air-conditioned private tour bus to locations in the itinerary Airport transfers in Jordan English-speaking guide for group events for 11 days (airport to airport) and assistance throughout trip Tips (guide, driver, hotel and restaurant staff, etc.) Lunches and dinners (including tips) as listed in the itinerary All local ground transportation to places in itinerary Speaker fees Entrance fees and admission to all places listed in itinerary All private concerts and events as listed in the itinerary Coordination and curation of all listed activities Pre-trip departure information Not Included Airfare to/from Jordan Airport transfers outside of Jordan Airline baggage fees Any expenses of a personal nature, such as telephone, mini bar, etc. Meals and drinks other than those listed in the itinerary Visa fee ($57.00 or 40 JOD per person). If a clear passport copy is provided at least 14 business days in advance, the tour operator will be able to obtain a visa for U.S. citizens free of charge. Otherwise, visas for U.S citizens can be obtained upon arrival at Queen Alia International Airport at the expense of the traveler. Non-U.S. citizens may be required to obtain a visa in advance and are responsible for confirming their own entry requirements and entry fees. Anything not listed in the itinerary 3 of 6
Terms and Conditions Payment A $1,500 deposit per traveler is required to complete registration for this trip. Your registration is not considered complete until your payment has been received. Full payment is due by February 15, 2019. I will pay with a check made out to the Authors Guild Foundation and mailed to 31 East 32 nd Street, Floor 7, New York, NY 10016. Please use the information below to charge my credit card. Card Type: Visa Mastercard Amex Discover Name on Card: Card Number: Expiration: CVV: Cancellation Policy There is a non-refundable $250 administrative fee for all cancellations made after any payment has been received. Cancellations prior to January 15 will result in a refund of all monies paid, except for the $250 administrative fee. Cancellations from January 15 to March 15 will result in a refund of all monies paid, except for $3,500 or $4,000 depending on double or single occupancy (this includes the $250 administrative fee). No portion of a payment kept for a cancellation penalty will be considered a tax-deductible donation. No refunds are available after March 15. We strongly recommend purchasing medical and trip-cancellation insurance from a certified third-party vendor. Unused Services and Refunds No refund or adjustment can be made for any portion of the services not used, such as voluntary nonusage of hotel accommodations, scheduled meals, or any planned activity described in your itinerary. 4 of 6
Responsibility and Liability Statement The Authors Guild Foundation serves only to assist in making necessary travel arrangements for its participating members, and in no way represents, or acts as agent for, transportation carriers, hotels, and other suppliers of services connected with this tour. The undersigned acknowledges and agrees that travel to foreign countries may potentially involve risks including, but not limited to, terrorism, diseases, search and/or seizure of property by customs or other governmental authorities, personal liability, risk of potential injury to the undersigned, loss or damage to property belonging to the undersigned, differing customs, and legal requirements. The undersigned acknowledges that the Authors Guild Foundation and its contractors, its and their officers, members, representatives, and employees, either in their official or individual capacities, are not liable to the undersigned for any injury, damage, loss, accident, delay, or other irregularity which may be caused by the defect of any vehicle or the negligence or default of any company or person engaged in performing any of the services involved. Additionally, the undersigned agrees that the Authors Guild Foundation and its contractors, its and their officers, members, representatives, and employees either in their official or individual capacities, are not responsible for any losses or expenses due to sickness, weather, strike, hostilities, wars, natural disasters, or other such causes. All services and accommodations are provided as is and are subject to the laws of the country in which they are provided. The Authors Guild Foundation and its contractors do not accept liability for any airline cancellation or delay incurred by the purchase of an airline ticket. Baggage and personal effects are the sole responsibility of the owner at all times. The Authors Guild Foundation reserves the right to make changes in the published itineraries whenever, in its sole judgment, conditions so warrant, or if they deem it necessary for the comfort, convenience, or safety of the tour participants. The Authors Guild Foundation also reserves the right to decline to accept any person as a participant in the tour, or to require any participant to withdraw from the tour at any time, when such an action is determined by the appropriate Authors Guild Foundation staff representative to be in the best interests of the health, safety, and general welfare of the tour group or of the individual participant. The Authors Guild Foundation and its contractors shall not be responsible for a delay or failure to perform due to causes or events not within its control, including, without limitation, an act of God or government, civil disturbances, fire or other catastrophe, electrical or computer failure, telecommunication failure, disruption of public transportation, storm, or other severe weather conditions. The undersigned has read carefully the schedule of activities for this tour. The undersigned recognizes that there is a moderate level of physical activity involved in the tour and the tour may require participants to walk relatively long distances and climb stairs and that such activities carry increased levels of risk by their very nature. The undersigned client accepts any risks thereof and the conditions set forth therein. To the extent allowed by law, client agrees to release and hold harmless the Authors Guild Foundation, its contractors, and its and their officers, members, representatives, and employees, either in their official or individual capacities from any and all liability for delays, injuries, or death, or for the loss of or damage to personal property however occurring during any portion of the program. I accept the terms and conditions of the sales agreement described in the preceding five pages for the Authors Guild Foundation trip to Jordan. 5 of 6
Traveler Name (please print): Date: Signature: Thank you for completing your registration form. Please sign and return it to us, along with a copy of the first page of your passport. By email to: landerson@authorsguildfoundation.org By mail to: The Authors Guild Foundation, 31 East 32 nd Street, Floor 7, New York, NY 10016 6 of 6