YEHUDI Fellowships: Zion National Park-Registration Name* First Last Date of Birth* Date Format: MM slash DD slash YYYY Email* Cell Number*Parent's Contact information: Name, mailing address, email, cell:*In case of emergency, please contact:*Legal Name (as appears on ID you will travel with)*Airline tickets will be purchased with this name so please double check spelling.Flights*This trip begins with a flight from Fort Lauderdale (FLL) or Miami International Airport (MIA) and is priced accordingly. Once flights are booked, they are non-refundable. Should it be impossible for you to fly from FLL or MIA please let us know below. YEHUDI will try but not guarantee to accommodate Any difference in airfare would be the sole responsibility of the participant. I understand. Please book my flight with the group from FLL or MIA It is absolutely impossible for me to fly from FLL. Please contact me before booking flights Luggage*This trip is all inclusive including: Flights, lodging, food, programming. There may be additional charges for luggage at the airlines discretion. Any luggage, including carry-on luggage, fees are the responsibility of the participant. I understand and agree Dietary Restrictions*SWAGYEHUDI Prides itself on great SWAG. Please let us know what size sweatshirt or T-Shirt we can order for you. XS S M L XL XXL Commitment and Respect*YEHUDI is committed to creating an environment where every participant feels safe and respected. There will be a no tolerance policy towards any participant acting in ways that make other participants feel unsafe or uncomfortable . A violator can be dismissed from the program at any time at his or her own expense, including travel home. Violations include but are not limited to: Unwanted touching, being in the hotel rooms of participants of the opposite gender, lewd or inappropriate speech. I understand and agree Covid-19 Policies*YEHUDI's primary concern remains the safety and well being of each and every participant. Below please find the COVID policies for the YEHUDI Fellowships: Program. -Every participant must submit either: A negative result from a coronavirus test (PCR preferred) , taken within one week prior to the program OR Proof of Covid vaccination -Every participant must sign a health affirmation, confirming that he/she has not experienced any COVID symptoms in the past seven days and that he/she has not , knowingly, been exposed to anyone who is COVID positive in the past 14 days. -Masks must be worn during all indoor programming except when food is being served -Participants must sleep only in the rooms assigned to them Hand sanitizer and extra masks will be available at all times in the lodging facility. -All participants must sign a waiver indemnifying YEHUDI from responsibility should he/she contract Covid-19 during this program I have read, I understand and I agree to adhere to the policies stated above. Liability Waiver*By clicking "I confirm" below, you are confirming that you are participating in this program at your own risk. YEHUDI is not liable and shall not be held responsible for and injury, illness (covid or non-covid related) loss of property or loss of life, God Forbid. I Confirm Olami*YEHUDI is an affiliate of Olami. With programs in over 30 countries, Olami and its funding partners sometimes use independent verification firms to assure that programs are attended and impactful. By registering, I understand that I might be contacted by a verification firm for quality control purposes.* I agree to this policy Policy I agree to be contacted about future Mosaic sponsored opportunities Payment Information* Price: $399.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Billimg 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