Tour International Reservation Form

ISRAEL 10 DAY TOUR with 3 DAY JORDAN EXTENSION

INTERNATIONAL RESERVATION FORM

SAMUEL WARREN TOUR GROUP Contact Us For Exact Dates

Deposit:Your reservation will be confirmed upon receipt of your deposit. $500.00 for International air tours. Note: All prices based on International exchange rates, which are subject to change. Final Payment: Balance due $60 days prior to departure. Cancellation & travel Protection: Initial deposit is refundable up to 90 days from departure. Pilgrim Tours requires a $100.00 service charge for both Israel and China tour cancellation. After final payment is received, the amount refunded is based on penalties imposed by airlines, hotels, etc. Pilgrim Tours recommends that you consider trip cancellation and interruption insurance. Pilgrim offers optional insurance coverage as noted on the back of the itineraries.

Proof of US Citizenship: All International tours require a current passport. Your passport number must be recorded by a Pilgrim Tour agent when making your reservation. Send a copy of your passport along with this reservation form.

Responsibility: Pilgrim Tours & Travel is the principle and is responsible for the arrangements and services described in their brochures. Pilgrim Tours & Travel, its employees and agents cannot be held responsible, in the absence of their own gross neglect, for events over which they have no control, nor for acts and omissions by persons, companies or agencies, including hotels, airlines, restaurants, sea and land transportation companies, which are not directly controlled by Pilgrim Tours & Travel. Non US Citizens are responsible to fulfill appropriate entry requirements of destination country. Contact the local Consulate for information.

Please complete the reservation form

and return it with your Check, or Credit Card payment to:

Pilgrim Tours, Attention: Steve Fidler

PO Box 268, Morgantown, PA, 19543

Please Print this Form and Print Information Neatly.

See Prices and Additional Rates Below.

Tour Name: Israel 10 day Tour

Cost per person: $ ___________________

Date of Tour: June 6 - 15, 2005

[ ] Check here for Jordan 3 day extension

June 15 - 18, 2005

Departure City: _____________________

Number of Persons _______________________

________________________________

Deposit (per person): ____________________

X _____ (# of travelers) = $ ________

Cost of Insurance (per person): _____________

X _____ (# of travelers) = $ ________

Total Enclosed = $ ________________________

Check Master Card Visa American Express

Credit Card # ____________________________

Exp. Date __________________________

Name on Credit Card

___________________________________________________________________________

FIRST PASSENGER

SECOND PASSENGER (if payment on this form)

Full Name (as it appears on passport)

________________________________________

__________________________________

Passport Number _________________________

Passport Number ___________________

Issuing country of passport

or travel document _______________________

or travel document _________________

Date of birth (M/D/Y) ______________________

Date of birth (M/D/Y) _______________

Male Female

Your Street Address: _____________________

Your Street Address: _______________

City: ___________________________________

City: ____________________________

State:__________________________________

State: ___________________________

Zip Code: _______________________________

Zip Code: ________________________

Telephone Number: _______________________

Telephone Number: ________________

Emergency Contact not traveling

Name: _________________________________

Name: ___________________________

Telephone: _____________________________

Telephone: _______________________

Name of Roommate (if on a separate form)

________________________________________

________________________________

I decline the insurance offered by pilgrim and understand the cancellation policy. I may purchase insurance from another source. Insurance premium should be paid at time of deposit. I also have read and understand Pilgrim Tours' Terms and Conditions and will comply with the policies as stated.

________________________________________

_________________________________

Signature Required (First Passenger)

Signature Required (Second Passenger)

CLICK HERE FOR PRICES and ADDITIONAL RATES

If you have any questions Call our tour contact at Pilgrim Tours

Steve Fidler at 1-800-322-0788 ext. 116

Fax Number: 1 (610) 286-6262

Tell David you're coming with the Samuel Warren Tour

Group that's leaving on Contact Us For Exact Dates

Note: You may call Casting Director Samuel Warren at 619-264-4135

http://www.SamuelWarrenandAssociatesCasting.com