"Baruch HaBa 2017" nternational Conference & Intercessory Tour of Israel I Hosted by Tents of Mercy, Revive Israel & Tikkun International May 9 – May 18, 2017

REGISTRATION FORM Please register no later than March 1, 2017 (By email [email protected] or by Fax: 1-888-265-2871 (# in USA)  972-4-875-7792 (# in Israel Since registration is "first come, first serve" we strongly recommend that you register earlier than the March deadline .in order to reserve your place. Pre-payment is not required to be included in the list of attendees

Last Name ______First Name ______Street Address ______City ______State ______Zip Code ______Country ______Phone # ______Email Name of Congregation ______Pastor  Elder  ______Nationality ______*Age______Gender ______(Passport Number ______Language (1st) ______(2nd (.It is important to verify that your passport expiration date is valid for at least 6 months beyond the conference date ) .Please do not bring children younger than 13* .Touring can be physically demanding. We ask that participants over age 70 include a doctor's consent form* ______? Do you have food allergies or special dietary requests

(. Are you interested in a roommate? YES / NO (Please circle one ______If YES, please fill out the name of your preferred roommate If you do not have a roommate, we will do our best to find one for you. However, we cannot guarantee that we will be able ) .(to do so. Therefore, you must be prepared to pay the supplement for a single room

(. Do you want a single room? YES / NO (The cost of a single room supplement is $925.00  Will you be arriving early (before May 8th)? YES / NO If YES, would you like to reserve a room(s) at the Haifa Bay View Hotel (Haifa) through U Israel Tours? YES / NO ______?For what dates  Will you be staying on after the conference (after May 19th)? YES / NO If YES, would you like to reserve a room(s) at the Grand Court Hotel (Jerusalem) through U Israel Tours? YES / NO ______?For what dates To reserve rooms for dates before and after the conference, please send us the dates and number of guests and we will .provide you with an estimate

:FLIGHT INFORMATION ______Arrival Date ______Time of Arrival ______Airline ______Flight Number .(The conference cost includes transportation from Ben Gurion Airport to the Haifa Bay View Hotel (Haifa On Monday, May 8th, members of our hospitality team will be at the airport to greet arrivals and direct them to the bus. .Those arriving before or after May 8th will need to arrange their own transportation

______Departure Date ______Time of Departure ______Airline ______Flight Number The conference cost includes transportation from the Grand Court Hotel (Jerusalem) to Ben Gurion Airport Please note that this transfer is ONLY AVAILABLE on Friday, May 19th. You must be prepared to wait for up to 2 hours .before departing for the airport with other members of the conference leaving on different flights If you wish to travel from and to the airport independently (by train or by airport taxi), transportation information can be ] obtained by writing to Tents of Mercy at [email protected] or at the information booth upon your arrival at the [.airport

:TERMS OF PAYMENT  The total cost of the conference is $1750.00 per person (double occupancy). This covers the land portion of the :tour only. You are responsible for arranging and purchasing your own airline tickets. Please note the following is to be paid directly to U Israel Tours. A preliminary payment of at least 50% of the $1550.00 .a conference cost must be made by March 1st, 2017 and full payment by April 1st, 2017. Payments can .be made via bank transfer or credit card is to be paid in cash to Tents of Mercy to cover pre-arranged lunches, tips and expenses $200.00 .b .to hotels and guides. This will be collected upon arrival at the conference registration desk  A cancellation fee of $100.00 will be charged if money needs to be returned after the first deposit. If you cancel once full payment has been made (after April 1st), you may be charged an additional $925.00 (to cover the .cost of a single room) depending on your rooming situation

*METHODS OF PAYMENT