Booking Form for Trips with Rupert Drew to the Casa de Dom Inacio, Abadiania, Brazil to see Joao de Deus

Please print and return to Rupert Drew

BOOKING FORM
Group Travel to the Casa de Dom Inácio, Abadiânia, Brazil

Name:	_____________________________________________________

Address:	_____________________________________________________
	_____________________________________________________
	_____________________________________________________

Passport No:	______________	Country	________________________

		Is Visa necessary?	Yes ___ No ___

Brazilian immigration requires that your passport expiry date is a minimum of 6 months beyond your expected departure date from Brazil,so be sure this is the case, before leaving. UK & EC passport holders do not require visias for Brazil. If unsure if you need a visa, contact your nearest Brazilian consulate.

Please enrol me in (dep. date) _____________ Travel Group. For ____ weeks. I enclose cheque for £150 as deposit. I understand this deposit is non-refundable unless the trip is cancelled by the organiser.

I agree to pay the balance of £550 / £750 by _________________ (6 weeks prior to departure date). *(Cheques should be made payable to Rupert Drew) I enclose the following documents: 1) Copy of doctor’s certificate confirming my fitness to travel ( only if applicable). 2) Copy of my valid travel insurance policy (You MUST enclose this). 3) Cheque for £150.00 as deposit. 4) Copy of my Travel Insurance Document (required)

Contact details of next of kin or person to be contacted in case of emergency

Name:	_____________________________________________________
Telephone no:	_____________
Email:	_____________

* I have the following disabilities and will require these special arrangements to be made (e.g.provision of wheelchair,etc.):

______________________________________________________________________

______________________________________________________________________

My reasons for wishing to visit the Casa de Dom Inacio are: (continue over if necessary)

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

I understand and accept that Rupert Drew acts solely as organizer, guide and interpreter for members of his groups in Brazil and accepts no responsibility whatsoever nor liability of any kind for loss, damage to property or possessions, financial loss, illness, accident harm, delay or difficulty to myself, which may arise as a result of my stay in and my travel to,from and within Brazil.

Signed:	_________________________________	Date: __________________________



* Please Note that while the organizers make every effort to ensure the ease and comfort and safety of group members, those requiring frequent or constant care and attention MUST be accompanied by a competent personal assistant who is also required to complete an application form.