Journey To Italy Application

Application & Release Form

This Form Must Be Filled Out In Its Entirety
Mission Name and Date: Journey to Italy November 29th - December 10th, 2023
Number of participants registering:
Max of 2
YesNo
NoYes

Personal Information
Participant 1
NameFirst Name Last Name D/O/BDate of birth
MAILING ADDRESS

Street Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Participant 1 passport information
*Passports must be valid for at least six months beyond the return date of the mission
Upload an image of your passport image and signature page

Cancelof
YesNo

Participant 2
NameFirst Name Last Name D/O/BDate of birth
MAILING ADDRESS

Street Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Participant 2 passport information
*Passports must be valid for at least six months beyond the return date of the mission
Upload an image of your passport image and signature page

Cancelof
YesNo

Room Assignments
Number of rooms required
Double occupancy with one bedDouble occupancy with two bedsShabbat Observant
*Note: There is an additional charge of $1400 for single occupancy participants.

Billing & Payments

Payment and Cancellation Policy
Participant 1

A minimum $2500 per person deposit is due upon registration. Our trip provider will begin making reservations and purchasing tickets immediately. As a result, there are NO full refunds.
- If you register and then cancel by August 15th, you will receive a refund of 75% of all monies paid.
- If you register and then cancel between August 16th and September 15th, you will receive a refund of 60% of all monies paid.
- There are no refunds available after September 15th.
I accept the payment and cancellation policy.I understand that these payments are necessary in order to reserve speakers, transportation and hotel accommodations. I further recognize that these payments are payments for services (i.e., airfare, hotels, etc.) and not charitable contributions.
Participant 1Signature
Type name: Date Date

Participant 2

A minimum $2500 per person deposit is due upon registration. Our trip provider will begin making reservations and purchasing tickets immediately. As a result, there are NO full refunds.
- If you register and then cancel by August 15th, you will receive a refund of 75% of all monies paid.
- If you register and then cancel between August 16th and September 15th, you will receive a refund of 60% of all monies paid.
- There are no refunds available after September 15th.
I accept the payment and cancellation policy.I understand that these payments are necessary in order to reserve speakers, transportation and hotel accommodations. I further recognize that these payments are payments for services (i.e., airfare, hotels, etc.) and not charitable contributions.
Participant 2Signature
Type name: Date Date

Travel Arrangements & Additional Hotel Nights
You are responsible for your own flight arrangements.

Please note that the Journey will begin in Italy on November 29th. In order to be in Italy on time, you will need to depart Nashville by November 28th at the latest. Depending on the arrival times of individuals, we will arrange a transfer from the airport. Please plan on being in Venice by the morning of November 29th.
I / We will arrange own domestic and international flights
PLEASE INITIAL: I/WE understand that the Jewish Federation strongly recommends that each participant purchase travel insurance from a provider they choose which provides for reimbursement for trip delay, missed connections, sickness and/or accident medical expenses, lost baggage, personal effects, baggage delay, etc.

Affiliation
Synagogue affiliation: Agency affiliation:
Dietary and Meal Restrictions
Participant 1: Kosher Vegetarian Other Type a label
Participant 2: Kosher Vegetarian Other Type a label

Medical & Emergency Information
Participant 1:
Participant 2:

Emergency Contact

Must be someone not on the trip
Participant 1
Participant 2 (if different from participant 1)

PLEASE READ AND SIGN THE RELEASE FORMS THAT FOLLOW
Mission Name: Journey to Italy 2023

Date: November 29th - December 10th, 2023

Release of Liability for Death, Personal Injury, and Property Damage

Journey to Italy

I am aware of the risks of travel to Italy and travel worldwide, including risks associated with my safety and security. These risks include but are not limited to, property damage and loss, death, or injury by accident, disease, or terrorist acts. I am voluntarily participating in the Jewish Federation of Greater Nashville (JFED) Journey to Italy (the “Journey”) with a full understanding of these risks, and I assume and agree to accept any and all risks to my safety and security during the course of participating in the Journey.

I have read, or have had the opportunity to read, the current United States Department of State’s Italy's Travel Advisory found at http://www.travel.state.gov, to see if the Travel Warning has been superseded by a new Travel Warning.

I acknowledge and affirm that, notwithstanding any security arrangements that may be made by JFED, JFED does not guarantee and is not responsible for my personal safety or the safety of my property while participating in the Journey or any Journey-related activities, including, but not limited to, airline travel, ground transportation, meals, lodging, and recreational activities.

In light of the above and in consideration of being permitted to participate in the Journey, I do, for myself, my spouse, heirs, executors, administrators and assigns, release and forever discharge JFED, its respective subsidiaries, affiliates, predecessors, successors and assigns, and all of its respective past, present, and future officers, directors, shareholders, employees, agents, and contractors, and their respective heirs, executors, administrators and assigns (collectively, the “Releasees”), of and from any and every claim arising from or by reason of any bodily injury, personal injuries known or unknown (including emotional trauma), death, or property damage resulting or alleged to result from any accident, incident, or other episode that may occur, whether based upon the negligence of, or breach of contract by, any Releasee or any other party for whose acts or omissions any Releasee may be responsible in law or in fact, or any other cause or principle of law, as a result of my participation in the Journey or any activities in connection with the Journey.



This release contains the entire agreement between the parties to this release. This release supersedes any prior or contemporaneous agreements, understandings, and negotiations regarding its subject matter. This release shall be interpreted and enforced in accordance with the laws of the State of Tennessee and shall be as broad and inclusive as permitted by such laws. If any provision of this release is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and legal effect.



I have carefully read the foregoing release and understand its contents and acknowledge that this is a release of liability and such is a binding and fully enforceable contract between myself and JFED.

Having consulted, or having had the opportunity to consult, my own counsel as to its meaning and legal effect, I sign this release as my own free act.

Note: JFED requires that each adult 18 and over whose name appears on the same application, personally sign this security notice/release. Spouses, roommates, etc. may not sign for one another. Thank you for your cooperation.
Participant 1 Signature
Type name: Date Date
Participant 2 Signature
Type name: Date Date

Mission Name: Journey to Italy 2023

Date: November 29th - December 10th, 2023

Photo/Image Release

I hereby grant the permission, without reservation, to Jewish Federation of Greater Nashville (JFED) to take and to use photographs and/or sound/image recordings of me, to describe and to use the same for promotion of goodwill, public education, and/or fundraising and other related activities of JFED, and I waive any right to inspect or approve the photograph(s) or finished version(s) of works, including web site, incorporating the photograph(s).

I release JFED, its officers, trustees, agents, employees, independent contractors, licensees, and assignees (including photographers), from all claims that I may have or might have, for any cause of action arising out of taking and/or use of the photographs and/or any sound/image recordings, and/or description of the same, be it blurring, distortion, alteration, optical illusion, or use of composite form whether intentional or otherwise, that may occur or be produced in taking of photographs, or any processing toward the completion of the finished product unless it can be shown that they and the publication thereof were maliciously caused, produced and published solely for the purpose of subjecting me to conspicuous ridicule, scandal, reproach, scorn, and indignity.

I recognize that JFED owns the copyright (or may apply for copyright) in these photographs and other works and creations, and I hereby waive any claims I may have based on any usage of the photographs or works derived therefrom in any form, whether it be printed, projected, televised or transmitted via the web, or/and at any time, be it in the present or in the future, including, but not limited to claims for either invasion of privacy or libel.

I am of full age and competent to sign this release. I agree that this release shall be binding on legal representatives, my heirs, assigns, and me. I have read this release and I fully understand its contents.
Participant 1 Signature
Type name: Date Date
Participant 2 Signature
Type name: Date Date
Should be Empty:

Application & Release Form

Personal Information

Participant 1

Participant 2

Room Assignments

Billing & Payments

Payment and Cancellation Policy

Travel Arrangements & Additional Hotel Nights

Affiliation

Dietary and Meal Restrictions

Medical & Emergency Information

PLEASE READ AND SIGN THE RELEASE FORMS THAT FOLLOW