Croatian Mir Center

DEPARTURE DATE:

DESTINATION:

DEPARTURE AIRPORT:

LAST NAME (as per passport):

FIRST & MIDDLE NAMES (as per passport):

DATE OF BIRTH:

GENDER: Male Female

SINGLE ROOM: Yes No

ROOMING WITH:

MAILING ADDRESS:

CITY:

STATE:

ZIP:

E-mail address:

Home Phone:

Mobile Phone:

Emergency contact (name, phone, email):

OTHER INFORMATION:

Country that issued your passport:

Passport expiration date:

NOTES or SPECIAL REQUESTS:

Click here if you have read and agree to the Terms and Conditions for this pilgrimage. Terms and Conditions

Upon receipt of your registration form, a reservation will be made and a confirmation emailed to you, at which point a deposit of $500.00 per person will be due. The balance is due 60 days prior to departure. Payments can be made by check or credit card by calling our office at 1-800-220-7729.

TRAVEL INSURANCE IS RECOMMENDED. PLEASE VISIT travelguard.com FOR MORE INFORMATION.

Pilgrimage Registration