Registration form

South America - New Year's Eve Cruise

Registration Form

(Just print this page out and Fax (412) 344-3937, copy and paste it into an email, or mail it in.)

Name ______________________________________________________________Birth Date __________________________[ ] Male [ ] Female

(as it appears on your passport or birth certificate)

How would you like your name to appear (informally) on our group passenger list? ____________________________________________

Street __________________________________________________________ City/State/Zip ___________________________________________

E-mail ________________________________ Phone: (H)_______________________ (W) ______________________ (C) ______________________

T-shirt Size: [ ] S [ ] M [ ] L [ ] XL [ ] XXL

ACCOMMODATIONS:

[ ] Interior [ ] Ocean View [ ] Deluxe Ocean View with Veranda [ ] Concierge Class with Veranda

[ ] Prefer single room [ ] Please assign roommate [ ] Roommate Request___________________________________________________

PRE-CRUISE OPTION:

[ ] Please sign me up for the one-night Santiago Pre-Cruise Package

[ ] single occupancy [ ] double occupancy [ ] Roommate Request___________________________________________________

POST-CRUISE OPTIONS:

Option #1:

[ ] Please sign me up for the 1-night Buenos Aires Package

[ ] single occupancy [ ] double occupancy [ ] Roommate Request___________________________________________________

Option #2:

[ ] Please sign me up for the 3-night Buenos Aires and Iguazu Falls Package

[ ] single occupancy [ ] double occupancy [ ] Roommate Request___________________________________________________

AIR TRAVEL:

[ ] Please contact me to make flight arrangements from ____________________________________________________airport.

[ ] I prefer to make my own flight arrangements.

PAYMENT:

[ ] Enclosed is a deposit of $550 (single occupancy $1,100). Full payment due by October 5, 2007.

[ ] Enclosed is a deposit of $250 for the Post-Cruise Package to Iguazu Falls (Option #2).

OR [ ] Enclosed is my full payment: $ _________________________(Make check payable to Amazing Journeys)

Charge my: [ ] Visa [ ] MC [ ] Amex [ ] Discover Acct. # __________________________________________________________

Exp. Date _________________________ 3 or 4 digit security code _________________________

Signature____________________________________________________________________________

[ ] Check here if you prefer to NOT include your name, address, phone number and email address on our " Cruise South America" passenger list.

[ ] Yes, enter me in the early booking cash drawing (deposit received by 6/30/2007).

[ ] Check if you are a past passenger member of Celebrity Cruise Line's "Captain's Club".

Please provide your membership # _____________________________________________________________________________________

Where did you hear about Amazing Journeys: ______________________________________________________________________________

[ ] I've read, understand and agree to abide by all terms, conditions and information stated in the brochure and the Responsibility Clause set forth below:

Signature _________________________________________________________________________________ Date ________________________

QUESTIONS AND REGISTRATION:

Call: Amazing Journeys at (800) 734-0493 or (412) 571-0220

or Bill Cartiff at the JCC of Greater Pittsburgh at 412-521-8011, ext. 849

E-mail: info@amazingjourneys.net or bcartiff@jccpgh.org

Mail: Amazing Journeys, 733 Valleyview Road, Pittsburgh, PA 15243

Fax: Amazing Journeys at (412) 344-3937 Visit: www.amazingjourneys.net

Responsibility. By signing our reservation form, you agree to the following: Amazing Journeys , LLC and the Jewish Community Center of Greater Pittsburgh act only in the capacity of agents for Celebrity Cruises, South American Tours and the suppliers of the travel services named in your itinerary or otherwise providing service in connection with this trip (“the Suppliers”), including cruise lines, airlines, hotels, sightseeing tour operators, bus lines, shore excursion companies, and providers of entertainment. We assume no responsibility for any personal injury, property damage, or other loss, accident, delay, inconvenience, or irregularity which may be occasioned either by reason (1) any act or omission of any of the Suppliers (2) any matter beyond our exclusive control including but not limited to a delay or cancellation of a flight that causes the participant to miss any portion of the trip. We do not guarantee any prices or the quality of any services. We have no special knowledge regarding the financial condition of the Suppliers, unsafe conditions, health hazards, weather hazards, or climate extremes at locations to which you may travel. For information concerning possible dangers at destinations, we recommend contacting the Travel Warnings Section of the U.S. State Department at (202) 647-5225 or www.travel.state.gov and click on “Travel Warnings.” For medical information, we recommend contacting the Centers for Disease Control at (877) FYI-TRIP or www.cdc.gov/travel. You assume full and complete responsibility for checking and verifying all passport and visa requirements of the destinations, as well as the conditions regarding health, safety, security, political stability, and labor or civil unrest at such destinations. We reserve the right to change the itinerary of the trip, delete and/or substitute cities to be visited, change the class of service and the mode of transportation, all without prior notice, to the extent that such services and accommodations offered cannot be supplied due to delays, unsuitability, mechanical problems, weather, change of ownership or other causes beyond our exclusive control. Any additional costs will be borne by you. We further reserve the right to withdraw the trip prior to the date of departure. Further, we reserve the right to decline to accept or decline to retain any participant should such person's health or deportment impede the operation of the trip or enjoyment of any other participant. In such case, a refund of unused land tour services is the limit of our liability should such person be required to depart the trip. You agree that we may use photographs of you taken on this trip for publication on our website or in marketing material. The rights and remedies made available under this agreement are in addition to any other rights and remedies available under applicable law. However, we offer refunds under this agreement with the express understanding that the receipt of that refund by a passenger waives the additional remedies, and under no circumstances will be responsible for damages in excess of the amount paid to us by you. All claims must be submitted within 30 days after return of the trip. Any dispute arising out of or in connection with this agreement shall be determined solely by the courts in Pittsburgh , Pennsylvania , and the participant hereby consents to the jurisdiction of said courts.