Karuna Center for Peacebuilding · 2018 Summer Delegation to Bosnia and Herzegovina

Step 1: Accommodations

If you are traveling alone, you have two options for your accommodations: You can either share a room with another delegation member, or pay a little extra to have a single (private) room to yourself. If you are traveling as a pair, you can either enroll as a pair (and pay together), or you can each register/pay individually and then let us know who you would like as a roommate. There is no discount for couples or groups.

Rooming arrangement (choose one)

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Single traveler in double room ($1,997) - A roommate will be arranged from the delegation

Single traveler in private single room ($2,350)

Pair of travelers in shared double room ($3,994 for both)

Step 2: Your contact information (single traveler):

Step 2: Your contact information (pair of travelers):

Name

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First Name

Last Name

Name

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First Name

Last Name

Gender

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Name (Traveler #1)

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First Name

Last Name

Name (Traveler #2)

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First Name

Last Name

Phone

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Phone (traveler #2)

Email

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Verify Email

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Email #2 (optional)

Verify Email

Mailing Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Traveler #2 has a different mailing address

Mailing Address #2

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Step 3: Emergency Information

In the space below, please provide (1) an emergency contact (name and phone number) who is not a member of the trip; and (2) any relevant health concerns.

Emergency contact & health information:

Step 4: Waiver of Liability

Waiver of Liability (to be signed below): I have read the itinerary and other information in the accompanying brochure for Karuna Center for Peacebuilding’s Witness Peacebuilding in Action: Bosnia and Herzegovina trip, and I recognize and accept all risks thereof. I understand and agree on behalf of myself, my dependents, heirs, administrators and assigns to abide by the conditions set forth under the “Understandings & Responsibilities” on this registration form, and to release and hold harmless Karuna Center for Peacebuilding and any of their officers, employees, agents, licensees, or representatives, from any and all liability for delays, injuries, or death, or for the loss of property in relation to the program Witness Peacebuilding in Action: Bosnia and Herzegovina, June 26 - July 12, 2018. By typing my name below, I also certify that I do not have any mental or physical condition that would create a hazard for myself or other participants in the program.

Understandings & Responsibilities: The Karuna Center for Peacebuilding reserves the right to make changes in the published itinerary when conditions warrant, and to cancel the trip at any point before June 26, 2018 with full refunds for all trip registration fees and deposits made. Karuna Center also reserves the right to decline or accept any person as a member of the tour and also to require any participant to withdraw from the tour, at any time, if such action is determined by the Karuna Center to be in the best interests of the welfare of the tour group or the individual participant. Under such circumstances, no refund will be made. Baggage and personal effects are the sole responsibility of the owners at all times. Dates, schedules, and program details are subject to change and revision.

Your Signature:

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By typing your name above, you are signing the Waiver of Liability electronically and accepting the terms of the Understandings & Responsibilities set forth above. You agree your electronic signature is the legal equivalent of your manual signature on this agreement.

Your Signature (traveler #2):

By typing your name above, you are signing the Waiver of Liability electronically and accepting the terms of the Understandings & Responsibilities set forth above. You agree your electronic signature is the legal equivalent of your manual signature on this agreement.

Step 5: Payment Options

Please choose a payment option below that matches your choice of accommodations. Prior to April 30, you have the option of putting down a non-refundable deposit of $1,000 per person to hold your place in the trip. Full payment is due April 30, 2018.

Payment Today:

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$1,000 - DEPOSIT (SINGLE) - Remaining balance due April 30, 2018

$2,000 - DEPOSIT (PAIR OF TRAVELERS) - Remaining balance due April 30

$1,997 - Payment in Full: Single Traveler in Shared (Double) Room

$2,350 - Payment in Full: Single Traveler in Single (Private) Room

$3,994 - Payment in Full: Pair of Travelers in Double Room

Optional: A little more about you

We would love to know more about your interest in this trip so that we can make sure everyone feels ready, included, and engaged. Thank you for any and all thoughts you choose to share!

Can you tell us a little bit about yourself (e.g. your approximate age, your occuption) and why are you interested in participating in this program? What do you hope to experience and learn?

How much do you know about Bosnia and Herzegovina? Do you have expectations of what the country will be like?

What are your main concerns about participating in the program? What type of training, information or other support do you feel you need to receive before the trip to feel prepared?

Online Registration and Payment Form

Step 1: Accommodations

Step 2: Your contact information (single traveler):

Step 2: Your contact information (single traveler):

Step 2: Your contact information (pair of travelers):

Step 3: Emergency Information

Step 5: Payment Options