Keshet: The Center for Educational Tourism in Israel
PO Box 8540 Jerusalem, 91084 Israel
Tel: 972 2 671-3518 Fax: 972 2 671-3624

Temple Emanu-el of Westfield

Family Israel Discovery

December 19-20, 2013

$4898 Air & Land Package – Double Occupancy Hotel Accommodations

Plus $635 Airline Taxes and Fuel Surcharges (Subject to Change)

Based on a minimum of 22 participants; If fewer than 22 participants, the price per person will increase

Please check one of the following:

□ Full Land & Air Package □ Land Only Package

Please complete, sign and send this 2 page registration form with the signed disclaimer and $500 deposit

per person payable to Educational Encounters Intermational (EEII) to arrive by December 14, 2012 at:

Educational Encounters International, Inc. (EEII), 180 East Prospect Avenue # 142 Mamaroneck, NY 10543

□ Include a photocopy of the first page of each passport. Your passport must be valid through December 28, 2013. If you are renewing/applying for a passport please complete & submit the registration form with deposit & forward missing information later.

□ Please provide the information requested below for each person registering. Each name must be spelled exactly as it will appear on your passport. U.S.& Canadian passport holders need no visa to enter Israel. For other nationalities, check with the nearest Israeli consulate.

□ Please note any special health/dietary considerations of which we should be aware, including physical limitations, allergies etc

Registration Information:

Name
(as appears on passport) / Passport Number
& Expiration Date / Date of Birth / Roommate / Health/Dietary Issues

Your Contact Information:

Your Name:______

Your Mailing Address:______

______

Your E:Mail #1:______Email #2: ______

Your Phone Numbers:

(Cellular) ______-______-______(Home) ______-______-______

(Work) ______-______-______(Fax) ______-______-______

Emergency Contact Information:

Name______Relationship to you______

Emergency contact phone numbers & e-mail:

(Cellular) ______-______-______(Home) ______-______-______

(Work) ______-______-______E-mail:______

► Trip Insurance: Keshet urges you to purchase travel insurance to cover trip cancellation and/or interruption. We have made arrangements with SMS Travel Insurance of Omaha, Nebraska to facilitate this. SMS has over 25 years of experience as insurance brokers and can help you choose the policy that best meets your needs. Let them know that you are traveling with a Keshet group. Please note that many insurance policies require purchase within 14 days of the your date of registration for the trip. Dani Eisenstock at SMS Travel Insurance can be reached at US phones 1-888-747-3773 (toll free) and 1-402-343-3681. E mail: Web site:

► Disclaimers

Airline taxes and fuel surcharges are subject to increase/decrease without advance notice by the airlines, until the date that tickets are actually issued. We can ticket after we receive full payment from ALL trip participants.The charge for taxes and fuel surcharges will be added to your final bill at the rate known at that time. Should these fees increase between the final billing and actual ticketing, we will send you a supplemental bill for the increase

Keshet: The Center for Educational Tourism in Israel/Educational Encounters International, Inc. acts only as an agent for the tour participants in making arrangements for hotels, transportation, touring, restaurant, or any other services in connection with the itinerary. We will exercise reasonable care in making such arrangements. However, we do not assume any liability whatsoever for any injury, damage, loss, accident, delay or irregularity to person and property because of an act of default of any hotel, airline carrier, restaurant, company, or person rendering any of the services included in the tour. The right is reserved to cancel or change itineraries or to substitute comparable service without notice. The right is reserved to decline or accept or retain any tour passengers should such person's health or general deportment impede the operation of the tour to the detriment of the other tour participants. Rates are based on standard rooms unless otherwise indicated. No refunds will be given for unused package inclusions.

Itineraries may be altered as a result of security, logistics or weather concerns determined by either Keshet or the contracting group. Costs associated by such changes are the responsibility of the group. In the event of devaluation of the US dollar, hotels and other vendors may add surcharges; Keshet reserves the right to pass such increases on to trip participants. Keshet may use photographs/videos taken on the trip for promotional purposes. If you do not want your photo/ video to be used please notify us in advance.

Pricing is based on a stated minimum number of participants. Should the group number fall below the minimum, Keshet reserves the right to alter the program and/or recalculate the pricing.

Deposit and Payment Schedule

January 21, 2013 / Deposit of $500 per participant (applied to total payment)
March 1, 2013 / 50% of total trip cost
April 12, 2013 / Payment due in full

Refund Schedule For cancellation or non-participation for any reason

Cancellation after January 21, 2013 / Full refund less $100 per person
Cancellation after March 1, 2013 / Full refund less $500 per person
Cancellation after April 12, 2013 / Full refund less $2770 per person
Cancellation after June 2, 2013 / No Refund

My signature below indicates that I have read, understood and agreed to the above and that all information provided by me is complete & accurate.

______

Signature of Participant Date