Israel Trip 2023 | Application

Israel Trip 2023 | Application

April 23 – May 3, 2023
Dates & Policies
Temple Emanu-El Streicker Center Israel Trip 2022 One East 65th Street | New York, NY 10065 israel@emanuelstreickernyc.org | (212) 507-9580 TRIP DATES: April 23 – May 3, 2023 PRICING + DUE DATES Double Occupancy: $13,750 per person Single occupancy supplement: $3,500 Non-Temple Emanu-El Member Fee: $1,500 per person A $2,500-per-person deposit due upon registration (fully refundable until January 23, 2023.) Balance due by January 23, 2023. No refunds after January 23, 2023. This is an ALL-INCLUSIVE trip, covering: VIP transfer from Ben-Gurion International Airport to hotel All accommodations (5-star hotels) All experiences, meals and activities Luxury bus + private tour guide All tips A souvenir photo book Not included: Airfare Travel insurance (recommended) The trip is 21+ only HOW TO PAY * Complete, sign and submit this application. * Pay by credit card online at https://streicker.nyc/israel/payment * Or, pay by check: Mail check payable to "The Temple Emanu-El Streicker Center." (Include a copy of your application, or a note with the traveler contact information.) Mail to: Temple Emanu-El Streicker Center, Israel Trip, One East 65th Street, New York NY 10065.
Temple Emanu-El Streicker Center
Israel Trip 2022
One East 65th Street | New York, NY 10065
israel@emanuelstreickernyc.org | (212) 507-9580

TRIP DATES: April 23 – May 3, 2023

PRICING + DUE DATES

Double Occupancy: $13,750 per person
Single occupancy supplement: $3,500

Non-Temple Emanu-El Member Fee: $1,500 per person

A $2,500-per-person deposit due upon registration (fully refundable until January 23, 2023.)

Balance due by January 23, 2023. No refunds after January 23, 2023.

This is an ALL-INCLUSIVE trip, covering:
- VIP transfer from Ben-Gurion International Airport to hotel
- All accommodations (5-star hotels)
- All experiences, meals and activities
- Luxury bus + private tour guide
- All tips
- A souvenir photo book
Not included:
- Airfare
- Travel insurance (recommended)
The trip is 21+ only

HOW TO PAY

* Complete, sign and submit this application.

* Pay by credit card online at https://streicker.nyc/israel/payment

* Or, pay by check: Mail check payable to "The Temple Emanu-El Streicker Center." (Include a copy of your application, or a note with the traveler contact information.) Mail to: Temple Emanu-El Streicker Center, Israel Trip, One East 65th Street, New York NY 10065.
Contact & Passport Information
Full Name (AS IT APPEARS ON YOUR PASSPORT)*

First NameMiddle NameLast Name
Preferred Name (if different)
Hebrew Name
You may type in the transliteration or Hebrew text if your computer supports that.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Date Of Birth*

MonthDayYear
Birth Place*
City, State, Country
Email Address*
Passport Number*
Passport Expiration Date*

MonthDayYear
Country of Citizenship*
Travel Info & Preferences
Are you a Temple Emanu-El Member?

Yes, I am a member.No, I am not a member (additional $1500 fee).
Accomodation Type*

Single Room (additional $3500)Double Room (specify at right)
Sharing a room with:*
Full Name
Total Number in Your Group*
(Complete an application for EACH PERSON)
Names of additional people in your group:*
Please list full names
Dietary Restrictions or Requirements (if any)
E.g., Vegetarian, Vegan or other restrictions
T-Shirt Size (adult sizes only):
Emergency Contact

(In the United States)
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
Emergency Contact Email
example@example.com
Liability Release Statement

This electronic signature is the equivalent of a written signature. Ensure you have read and agree to all policies all this page before signing. You warrant that the information you have provided is correct to the best of your knowledge.
Liability Release Statement
I have read and agree to the disclaimers and policies on this form and I hereby release and discharge Temple Emanu-El, its agents, employees, officers, directors, shareholders and successors from and against any and all liability arising from my participation in this trip. I agree that this release will be legally binding upon myself, my heirs, successors, assigns legal representatives, it being my intention to fully assume all risk of travel and to release Temple Emanu-El from any and all liabilities to the maximum permitted by law.
I, {fullName}, have read the disclaimer stated above and I hereby release and discharge Temple Emanu-El, its agents, employees, officers, directors, shareholders and successors from and against any and all liability arising from my participation in this trip. I agree that this release will be legally binding upon myself, my heirs, successors, assigns legal representatives, it being my intention to fully assume all risk of travel and to release Temple Emanu-El from any and all liabilities to the maximum permitted by law.
Signature*

Clear
Sign with mouse or finger.
FULL NAME*
Type your full legal name.
DATE*
Type the date you are signing this application.
Should be Empty:

Israel Trip 2023 | Application

Contact & Passport Information

Travel Info & Preferences

Emergency Contact

Liability Release Statement