Portugal Registration – Double Occupancy Portugal Women's Wellness Retreat Double Occupancy Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Personal DetailsFirst Name *Last Name *Address *Address Line 1CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhone *Email *Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Who referred you? *How did you hear about the retreat?Please list roommate name, or request 'roommate matching'. *Do you have any allergies or dietary requirements? *YesNoPlease specify food allergies or other requirements:Flight from which country? *Emergency ContactName *Phone *About you - to determine suitability for this tripPlease describe yourself. *Why do you want to come on this retreat? *What do you seek to gain on this retreat? *What experience to you have with international travel? *How do you feel when you travel? *How do you deal with unexpected circumstances, particularly in travel? *How do you deal with new situations and new people? *Please mention any medical conditions that can affect you on a travel retreat. *Open-minded, flexible, and pleasant attitude *I understand that an open-minded, flexible, and pleasant attitude is required when traveling, since variables and circumstances may arise which are beyond our control. *Eligibility and suitability *I understand that all applicants are interviewed to determine eligibility and suitability for this trip. *Cancellation Policy *I have read and fully understand the cancellation policy. *The registration deposit of $500 is non-refundable for any reason. Cancellation after Nov 4th (or if you do not show up, or you leave early for any reason) results in a total loss of funds. If I can fill your place after cancellation, I will offer a refund less the $500 non-refundable deposit. If you need to cancel before Nov 4th, you will get a full refund less the $500 non-refundable deposit. You can transfer the amount of your deposit/balance to a future international retreat (excluding the Nahsholim Israel retreat), as long as there is space available in the retreat that you'd like to attend. You may transfer your retreat balance one time. We reserve the right to cancel the trip if it does not meet minimum registration. It is highly unlikely this will happen, but if it does, your payment is refunded in full. Trip cancellation insurance is always recommended whenever making travel plans. Our retreat travel agent can assist you with your travel (medical) insurance and trip cancellation insurance.NextWomen’s Wellness Travel Retreat Algarve, Portugal RELEASE OF LIABILITY AND ASSUMPTION OF ALL RISKS Please read carefully, this is a legally enforceable waiver of rights. Assumption of Risks I First Name *Last Name *, acknowledge that I have voluntarily applied to participate on the trip designated on this application. I am voluntarily participating on the retreat, tour or expedition with knowledge that travel to foreign countries and/or the remote areas visited by this trip involves numerous risks and dangers including, but not limited to, a risk of illness, injury or death, which may be caused by: forces of nature, civil unrest, terrorism, road conditions, injuries inflicted by animals, insects, reptiles or plants, trails, hotels, vehicles, boats or other means of conveyance which are not operated nor maintained to standards common in the United States, Israel, Canada, or the UK; high altitude accident, accident or illness without access to means of rapid evacuation or the availability of medical supplies; the lack of adequacy of medical attention once provided, and negligence on the part of Kosher Vacation Experts, their affiliated organizations and their employees, teachers, volunteers or other agencies. I acknowledge that the enjoyment and excitement of foreign travel/adventure travel is derived in part from the inherent risks incurred by travel and activity beyond the accepted safety of life at home or work, and that these inherent risks and the corresponding enjoyment and excitement contribute to the reason for my voluntary participation on this trip. I hereby accept any and all risks of illness, injury, emotional, trauma, or death and verify this statement. Release: As lawful consideration for being permitted by Kosher Vacation Experts, to participate on such trips and activities, I hereby agree that I, my heirs, legal representatives or any member of my family will not make a claim against or sue Kosher Vacation Experts, or any of their affiliated agents, employees, teachers or volunteers, for bodily injury, death, emotional trauma or property damage resulting from my participation in the retreat, tour or expedition. I therefore release and discharge Kosher Vacation Experts and their agents, employees, teachers and volunteers from and against any and all liability arising from my participation in the tour or expedition even though that liability may arise out of negligence or carelessness on the part of Kosher Vacation Experts, or their affiliate agents, employees, teachers or volunteers. If any portion of this agreement is unenforceable, the remaining portions shall remain in full force and effect. Under no circumstances shall Kosher Vacation Experts be liable to any tour participant for more than the land cost of the trip applied for in this document. I waive any charge-back rights and, in the event of dispute, requests for a refund will be made using the procedures described under “Cancellation and Refunds” as stated in the Terms and Conditions for this trip. All applications are subject to acceptance by Kosher Vacation Experts Upon acceptance of my application, this agreement shall be deemed to have been entered into in Israel and shall be construed according to the laws of the State of Israel. In the unlikely event a legal dispute should arise involving any subject matter whatsoever, I agree that the exclusive venue for any legal action shall be the State of Israel. Travel Insurance We recommend Trip Cancellation insurance or Trip Interruption insurance for this trip. Travel insurance is designed to reimburse you for non-refundable expenses in case of a trip cancellation as well as for other previsions such as: missed flight connections, medical expenses/emergency assistance coverage (if something happens to you personally), baggage & personal effects coverage (if they are lost or stolen), baggage delay (if your bags do not arrive with your flight and you have to buy clothing, and personal items) which could possibly be very costly. Please note that insurance policies vary tremendously and have various critical exclusions. We recommend you choose carefully based on your personal situation. Responsibility / Limitation of Liability Kosher Vacation Experts, an Israeli operation with its principal place of business in Israel, gives notice that services provided in connection with these itineraries are rendered by suppliers who are not agents or employees of Kosher Vacation Experts. All of the accommodations, tours, transportation and/or related travel services have been made by Kosher Vacation Experts only as an agent for the individual tour member. While every effort is made to make travel arrangements with reputable suppliers, a tour member expressly agrees that Kosher Vacation Experts shall not be liable for any delay, mishap, inconvenience, expense, irregularity, bodily injury or death to person, or damage to property occasioned through the negligence, wrongful or intentional acts, or default of any company or individual engaged in providing these arranged services. Each passenger conveyance, tour company, hotel accommodation, etc. is subject to the laws of the state or country where the service is provided. Kosher Vacation Experts shall not be liable, directly or indirectly, for bodily injury or property damage for any reason whatsoever, including, but not limited to the following causes: acts of G-d, pandemics, epidemics, detention, annoyance, weather, quarantines, strikes, civil disturbance, theft, negligence including negligence of Devora Ratner, default, changes in government regulations, terrorism, war or failure of conveyance to arrive or depart as scheduled. Kosher Vacation Experts reserves the right to substitute accommodations and group leaders and to alter the itinerary when deemed necessary or advisable. The right is also reserved to cancel any trip prior to departure. Kosher Vacation Experts is released from any and all liability for cancellation of any trip, or portion thereof, except for payment of a land cost as set forth in the section on "Cancellation and Refunds." Kosher Vacation Experts reserves the right to decline to accept or retain any person whose actions, physical heath, mental condition or general deportment impede trip operation or rights, welfare or enjoyment of other trip members. A refund based on the cost of unused land services is the limit of Kosher Vacation Experts responsibility. Kosher Vacation Experts is not responsible for any refunds should a presenter advertised as attending or leading a tour or conference cancel for any reason. However, should Devora Ratner choose to cancel his/her participation in this journey for any reason, every effort will be made to refund your deposit and payments made which have not been previously sent to foreign and air travel suppliers as outlined above. Devora Ratner is not responsible for any physical, mental, emotional, or any other reaction, trauma, or ailment during the trip or occurring afterwards, that participants may experience at the sites or from any leaders, workshops, or sessions of any kind, including private sessions with facilitators or presenters. Attendance on the trip indicates acceptance of this and all other provisions of this responsibility clause. Kosher Vacation Experts has recommended the purchase of appropriate travel accident insurance, baggage insurance, tour operation carrier default protection insurance, and trip cancellation insurance, and has made available explanatory information and policies, and the travel program member has the opportunity to purchase such insurance as protection against certain risks of travel to the planned destination. Travel program members are advised that travel insurance covers only what is included as stated in the travel insurance brochure. The airlines or transportation companies concerned are not held responsible for any acts, omissions or events during the time passengers are not on board their planes or conveyances. The passenger contract in use by the carriers concerned, when issued, shall constitute the sole contract between the airlines or transportation companies and the purchase of this travel program and/or passengers. Trip Member Responsibility Trip members have the responsibility to select a trip/retreat appropriate to their abilities and interests. Trip members are held responsible for being in sufficiently good health to undertake the trip. Trip members are responsible for preparing for this trip by studying the itinerary and pre-departure information sent by Kosher Vacation Experts and for discussing this itinerary with their personal physician. Trip members agree to accept and abide by all the terms and conditions outlined in the “Terms and Conditions” document for this journey. Trip members are responsible to obtain any required travel documents (and visas if necessary) and to make sure all documents are current and up to date. Trip members are responsible for complying with any health requirements and vaccinations of any countries visited on this journey. Trip members are also responsible for bringing the appropriate clothing, medicines, supplies and equipment as advised in the pre-departure information. Trip members are participants in group travel and are expected to hold each other in compassionate regard, and to interact with each other with respect. Knowing and Voluntary Execution I have carefully read and fully understand the contents of this agreement as well as all the conditions as stated under the heading "Terms and Conditions" (see attached pages) including those conditions regarding responsibility borne by trip participants and conditions regarding cancellations and refunds. I am aware that this is a release of liability and a legally binding and enforceable contract between myself and Kosher Vacation Experts and I sign it of my own free will. By signing I agree to the terms in this document: * Clear Signature Signature of retreat participant (Please sign your full last name.)Date: *Print name as signed *PreviousContinue to payment