Getaway Booking Form This form is to be completed only by those who have reserved their space on the Catholic Couples Getaway.Please fill in this booking form as soon as possible to complete your reservation. Thank you! Booking Form Name (as it appears on passport) for Husband:* First Middle Last Husband's Full name for Name Tag at Event (if different than passport) First Last Husband's Birthday* Date Format: MM slash DD slash YYYY Name (as it appears on passport) for Wife:* First Middle Last Wife's Full name for Name Tag at Event (if different than passport) First Last Wife's Birthday* Date Format: MM slash DD slash YYYY Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*How did you hear about this trip?Wedding Anniversary*Emergency Contact and Relationship to You*Emergency Contact Phone Number*Are there any dietary or other special requests that you would like us to know about? (Although we do our best to accommodate, we cannot guarantee requests will be honored by third party vendors)I confirm that my passport is valid for six months AFTER (August 2024) the return date my trip. I also understand it is my responsibility to make sure I am free to travel to the destination and am not prohibited from traveling to any of the countries/places I will visit for any reason.*YesNo, but I am applying for a passport/renewingI understand if I need to cancel my trip, my cancellation must be received in writing via email or by letter. It will be effective the date of receipt. The following cancellation charges per couple will apply. There is a $500 deposit required for all reservations, which after final payment is due can not be returned. 60 days before the Getaway there will be no refunds for missed or unused portions of your Getaway. The purchase of travel insurance is strongly recommended.*Fully Refundable - Before August 15, 2023 (charged 3% processing fee) Fully Refundable - Before September 15, 2023 (charged $500 non-refundable) 75% Refundable - Before October 15, 2023 50% Refundable - Before November 1, 2023 25% Refundable - Before December 1, 2023 No Refund after December 1, 2023YesI agree to the terms of service*I can read the terms online here. YesEmailThis field is for validation purposes and should be left unchanged.