Registration Form

Peroneal Information - (Please complete one application per person)

Name (as printed on your passport):

First Name

Middle Name

Last Name

First name to appear on your nametag (maybe a nickname):

Gender

Male

Female

Date of Birth

US Passport Holder:

Yes

Passport Number:

Date of Issue:

Date of Expiration:

If NO (Specify):

Street Address:

City

State

Zip Code

Home phone:

Work phone:

Mobile phone:

Please check one:

Double occupancy

Single occupancy ($450.00 additional)

Indicate the name of your roommate / Seeking:

EMERGENCY CONTACT

Name:

Number

Signature

(Please Sign) I acknowledge that airline tickets are non-refundable, non-transferable, and are subject to airline cancellation fees and policies. No registrations will be accepted without signed acknowledgement. I acknowledge that I have read, understood, and agree to the “Terms and Conditions” in the accompanying brochure. I agree to submit full payment 90 days prior to departure.

Card holder’s Details

Card holder’s name (print):

Card No:

Exp. Date:

Security Code on card:

Amount:

Billing Address:

City

State:

Zip:

Crown Of Bethlehem

Our goal is to eventually bring as many Christians to the Holy Land as possible. Therefore, we have decided to match any price for any trip going to the Holy Land. These prices do not compromise our service and quality. Moreover, when choosing us you will directly help Christian families in Bethlehem, Jerusalem, and neighboring towns, because we only employ Christians. Our employees there range from the bus driver, to local hospitality, as well as the guide – everyone is a native and a fellow believer. In keeping with the Psalmist’s exhortation, “Pray for the peace of Jerusalem! ‘May they prosper who love you’!” – (Psalms 122:6, RSVCE). Our prayer should call us to action. Our organization seeks for U.S. Christians, and many others abroad, to have a direct cause in helping to strengthen our brethren in the birthplace of our Lord and the birthplace of the Church.

Registration Form

Crown Of Bethlehem

Contact Info