Holy Land Registration Form
January 2027
Casting Nets Holy Land Pilgrimage. January 11-23, 2027
Registration Form for the Casting Nets Holy Land Pilgrimage, January 11-23, 2027 with Fr. Joseph Irwin and Fr. Wesley Schawe.
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Email
*
example@example.com
Name as it appears on your Passport
*
First Name
Middle Name
Last Name
Birth Date
*
-
Month
-
Day
Year
Date
Passport Number
Passport Expiration
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Month
-
Day
Year
Date
Name as you would like it to appear on your name badge
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Phone Number to contact while traveling
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact of family or close friend not traveling with you
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact relationship to you
*
Package for trip ($5950.00*) *estimated
*
Single, Solo (one bed) +($1050 Single supplement)
Single (one bed), (willing to share with another single) *(subject to Single supplement if not matched)
Double (1 bed, 2 people)
Twin (2 beds, 2 people)
Triple (3 beds, 3 people)
Name of Roommate(s) (if double or triple)
Air for trip
*
Airfare from departure destination (ICT or ORD)
Land Only (I will book my own air to Tel Aviv)(-$800 flight credit)
I would like more information about Business/First class options)
I would like help with my domestic flights
I have submitted my $500 deposit
*
I will send a check. (Payable to Duc In Altum, PO Box 656, Colwich KS 67030)
I would like to pay with Credit Card (4% charge will be applied)
I would like to pay for multiple people. (please submits names)
Someone else is paying for me. (please submit name)
I have secured my Passport. (Must be valid through 7/24/2026)
*
I have secured and submitted a copy of my passport
I have applied for my passport but it is still processing
I still need to apply for my passport
Travel Insurance
*
I have secured my own travel insurance (please submit policy number)
Please send a link to travel insurance
T-shirt size (unisex sizes)
*
Small
Medium
Large
XL
XXL
Other
Any dietary restrictions or other special needs?
I have read and agree to all of the terms and conditions of the tour contract of Casting Nets Ministries and Duc In Altum. CNMHLP0127
*
Please enter your name as your binding signature.
Submit
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