2024 Group Tour Registration Form: April 15

€500 Early Bird Reservation and Registration Form:

Florence to Assisi group trek, April 15-30, 2024. Please complete one per traveler
Name as you'd like it to appear on your name tag*

First NameLast Name
Email address*
example@example.com
Cell phone number*
Address*

Street Address

Street Address Line 2

CityState/Province

Postal CodeCountry
Rooming Preference*

SingleDoublePlease find me a roommate
Name of roommate (if applicable)

First NameLast Name
Name as it appears on your passport*

First NameMiddle NameLast Name
Passport number*
Place of birth*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Country where passport was issued*
Date passport became effective*

MonthDayYear
Date
Passport expiration date*

MonthDayYear
Date
Date of birth*

MonthDayYear
Date
Do you know of any health issues that may affect your ability to complete the itinerary?*

NoYes
If yes, please describe:
Are you being treated for any chronic condition that might affect your health on the tour? If so, please describe*
Emergency contact name*

First NameLast Name
Emergency contact relationship
e.g. sibling, spouse, friend, etc.
Emergency contact telephone number*
Emergency contact email address
example@example.com
Will you celebrate a birthday or wedding anniversary during the trip?

YesNoOther
If so, what is the date and the event?
e.g. birthday on mm/dd/yy, etc.
Terms and Conditions*
Signature: By signing this form you affirm that all the information included here is accurate and that you have read and understood the Terms and Conditions.

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Click "Save for Later" if you're not ready to make your deposit and would like to save your information.
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April 15 - 30 -- Florence to Assisi€500.00
Deposit now to save your place. Because our group walks are in high demand, Pilgrim Paths receives Early Bird Reservations so prospective walkers can reserve their place before prices are released. Once prices are announced, each person has 30 days either to turn their reservation deposit into a down payment for the trip or receive a full refund.

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€500 Early Bird Reservation and Registration Form: