Medjugorje 2013 Pilgrimage Reservation Form (1)Last Name: __________________________ First Name: __________________________________ Sex: M / F (Please print names as it appears on your passport. Any irregularity or cost incurred with name changes, after reservation, will be the responsibility of the pilgrim. ) (2)Address: ______________________________________________________________ ________________________ Phone: Work:_________________________ Home: ___________________________ Mobile: _________________________ (3)Passport Issuing Country: __________________________________ Expiry Date: _________________________________ (Any irregularity or cost incurred due to incorrect information provided, will be the responsibility of the pilgrim.) (4)I wish to join the Medjugorje Pilgrimage(s) departing from Toronto: June15 to June 26, 2013 at $ (Group A)July 27 to August 8, 2013 at $1, (Y outh Festival: June 25 to July 8, 2013 at $ (Group B)Youths aged 12 to 21 will be subsided $500 per head.) October 4 to October, 15, 2013 at $ For reservation, complete the Pilgrimage Reservation Form and return to Medjugorje Centre of Canada with deposit. Price includes: Round trip airfare, between Toronto via a European connecting city and Sarajevo. Round trip land transfer by motor coach between the airport at Sarajevo and Medjugorje. Accommodation in Medjugorje on sharing room basis. Breakfast and dinner daily in Medjugorje. Land transfer to and from churches and institutes close to Medjugorje. Talks given by the visionaries or guest speakers when available. A local licensed English-speaking pilgrimage director. Not included: Airport tax, lunches, gratuities for hotel staff and bus drivers. Address: 360 Highway 7 East, Unit L1 Suite 9, Richmond Hill, Ontario, L4B 3Y7 Tel: (416) Web site: Page 1 of 2

Insurance: I understand that I have to arrange my own trip cancellation insurance if so desired, and mandatory medical insurance. Deposit: $300 deposit is required at time of reservation. Deposit is NON-REFUNDABLE but is transferrable before full payment is due. Full Payment Full payment, being balance of pilgrimage price and deposit, is due latest 60 days before departure. Refund of payment is subject to the following cancellation policy. Cancellation Policy: Cancellation occurs between 60 to 90 days before departure – eligible for refund of 50% of the full payment. Cancellation occurs between 30 to 60 days before departure – eligible for refund of 33% of the full payment. Cancellation occurs between 30 to departure day – not eligible for refund. Refund for credit card payment is subject to 3% of the final payment amount as service fee. Reservation Deadline: 30 days before departure (Medjugorje Centre of Canada reserves the right not to accept any reservation) Special Needs (if any) : ___________________________________________________________________________ In case of emergency, contact: ______________________Telephone: ______________Relationship: ____________ I wish to share a room with _____________________ Please assign me a roommate (s) ________________ Signature: _______________________________________ Date: ____________________________________ Please pay cash or by cheque made payable to Medjugorje Centre of Canada A 3% service fee, per transaction, will be levied for payment by credit card “If you knew how much I love you, you would cry for joy.” (January 3, 1982) Page 2 of 2