WENDT TOURING, INC. REGISTRATION FORM COMPLETE ONE FORM PER PERSON

TOUR NAME: POPE FRANCIS PAPAL VISIT TO PHILADELPHIA PRESENTED BY: ST. SUSANNA CHURCH TOUR DATES: SEPTEMBER 25-28, 2015 Please print clearly: Domestic travel requires an official photo id such as a driver’s license.

NAME (exactly as stated on ID):______

GENDER: M / F DATE of BIRTH: (Print name of month, day, and year ______

Contact Information: MAILING ADDRESS:______Street ______City, State, Zip Code

TELEPHONE NUMBERS: Home: ______Cell: ______

EMAIL: ______

For name tag purposes, how do you wish to be addressed? ______

Name of roommate (if applicable)______

Please circle one: Insurance: Yes No

Will you be celebrating or honoring a birthday, anniversary or other special occasion on this trip? ____yes ____no Date of Anniversary______Date of Birthday______Date/Type of special occasion______Special Requests: ______(i.e., dietary restrictions)

Payment Policy: A $100.00 per person deposit is due immediately to secure your reservation with the balance due by July 1, 2015. Make checks payable to St. Susanna Church and mail to 616 Reading Road, Mason, OH, 45040 – Phone: 513-398-3821.

Refund Policy: Cancellations are subject to penalties. An optional trip cancellation insurance is available for $36.00 per person for double, triple or quad occupancy and $43.00 per person single occupancy. Insurance premium is due with initial trip deposit.

IMPORTANT: Be advised that there will be a considerable amount of walking and standing throughout this trip. Additionally, the World Meeting of Families event organizers are now warning that travelers may be directed to use public transportation (regional rail, subway, etc.) in to and out of downtown Philadelphia. Should this become necessary, a transportation surcharge will be added to the trip price.