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The Jewish Experience Living Legacy Pilgrimage Registration - January 12-19, 2020

Please complete one registration form for each person who will be traveling.

Contact Information
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Prefix
First Name
Last Name
Suffix

Please include your full first and last name as you'd like it to appear on your name tag
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

More About You
As we're planning each Pilgrimage, it's helpful to know a little about you.
Do you belong to a church, congregation, synagogue, mosque or other faith community?
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No acronyms please, except for UU

MM/DD/YYYY (01/01/1955). It's important to have your birthdate in order to purchase museum tickets based on age.
Select as many racial/ethnic identity(ies) you claim. Choose other if your race/ethnicity is not listed and tell us more in the box below..

Include whatever additional information you'd like about your race/ethnicity.
Identity and Roommate Information

Type full first and last name
Medical/Emergency Needs and Information
Please note and describe any additional support you may need during the LLP-YCRP
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Identify any life-threatening allergies, including food-allergies

Note any medical needs you have and any special accommodations you need in your hotel rooms
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Dietary Restrictions

We make every effort to accommodate special dietary restrictions based on health needs. Please check all the types of foods you DO NOT eat under any circumstances.

For example, if you're vegetarian and gluten-free, check "Beef," "Pork," "Chicken," "Fish," "Shellfish," and "Gluten," as the foods you will not eat. If you're an omnivore -- in other words, you have no dietary restrictions -- check "I have no dietary restrictions."

This trip cannot provide fully kosher meals by traditional, Orthodox standards. Our meals will be taken in restaurants, none of which is equipped to do that. At the same time, we want to respect the dietary needs of our Jewish participants as best we can and facilitate their participation. If you are Jewish, please use this checklist to enable us to do that:
Referral Information
How did you hear about this Living Legacy Pilgrimage. Please check all that apply.

In what other way(s), did you hear about the Living Legacy Pilgrimage?
Payment Information

General rates apply after September 30, 2019. 

Scholarship registrants: If you've been approved for a scholarship, enter the amount you are responsible for paying in the open box. If you have been granted a full scholarship, you are responsible for the minimum payment of $50, so enter that in the open box. 

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Scholarship Fund Donation

We encourage those who are privileged by means of their color, or other means, to contribute a full or partial registration to our Living Legacy Project IRA account (Individual Reparation Account). This amount will allow a person whose life has been impacted by color discrimination or by the legacy of enslavement and/or racism to fully participate in the pilgrimage. All of us will be richer for these reparations.

The value of this Living Legacy Pilgrimage is priceless. By donating toward the cost of the trip, you have an opportunity to take concrete action toward healing the wounds of racism.

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Consents
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Throughout the Pilgrimage, LLP staff takes photos and videos for use on social media and in promotional and/or educational materials for the Living Legacy Project. We do not identify subjects in the photos by name without explicit permission. However, we will use anonymous photos unless you tell us that you do not want your photo used. In this case, we will make every effort to not include your image in photos and videos. However, we ask for your help in staying out of staged group photos and asking other participants to please not take your photo.
Prior to the Pilgrimage, we distribute a roster of participants to everyone who is registered for the trip. This includes your name, home city, and email address. Do we have your permission to include you on this list?
Participant Agreement

Responsibility/Liabilities

The Living Legacy Project, Inc., under the fiscal agency of First Unitarian Universalist Church of Richmond, VA, acts only in the capacity of agent for the suppliers of the travel services named in the Itinerary or otherwise providing services or goods in connection with the tour (the Suppliers”), such as hotels, bus lines, museums, and hotel shuttle services. We assume no responsibility for any personal injury, property damage, or other loss, accident, delay, inconvenience, or irregularity which may be occasioned either by reason (1) any act or omission of any of the Suppliers (2) any matter beyond our exclusive control including but not limited to a delay or cancellation of a flight that causes you to miss any portion of the Pilgrimage. We have no special knowledge regarding the financial condition of the Suppliers, unsafe conditions, health hazards, weather hazards, or climate extremes at locations to which you may travel.

You agree to release The Living Legacy Project, Inc. and the First Unitarian Universalist Church of Richmond, VA, from liability for any matter for which we disclaim liability under this Agreement. You agree to indemnify and hold us harmless from and against our liability to third parties arising out of your or your companions’ actions or omissions.

Any dispute related to the Pilgrimage shall be governed by Virginia law without regard to conflict of laws principles. The federal or state courts in Virginia shall be the exclusive forum for any lawsuit related to the tour, and you consent to the personal jurisdiction by said courts. You agree to present any claims against us within 30 days after the tour ends and to file within one year of the incident, and you acknowledge that this expressly limits the applicable statute of limitations to one year.

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