Hawaii Fellowship Registration Royal Caribbean Radiance of the Seas April 27-May 9, 2014 NAME AS ON PASSPORT: Name you

like to be called by: ADDRESS: PHONE: COUNTRY OF CITIZENSHIP: HOME CONGREGATION (church): CABIN CATEGORY (circle one): Cat. M, Cat. L, Cat. H, Cat. G, Cat. E1, Cat. D1 Description of cabins on Royal Caribbeans website: www.rccl.com CRUISE DEPOSIT: $450 PER PERSON with REGISTRATION FORM PAYMENT: Dec. 15, 2013 Cost per person: Rooming With: FINAL EMAIL: M/F BIRTHDATE:

MEDICAL CONDITIONS or special needs: INSURANCE: Please circle if you would like insurance information. After final payment, full refund only with insurance. I understand that if I do not purchase insurance, I am responsible for my own health insurance for this trip as well as for any monetary loss due to cancellation after my final payment deadline. Signed: PAYMENT: CREDIT CARD/DEBIT CARD ONLY Credit Card type: Number: Name on credit card: Expiration Date: I authorize Cruizin With Sally/Royal Caribbean Cruises to charge my credit card for the amount of the deposit/final payment. Signed: I authorize Disciples Today to charge my credit card for organizational fees. (This $300 organizational fee will be charged to your card July 1, 2013. $350 if you registered after Sept. 30, 2012.) Signed: Please scan and e-mail this form to sallyhooper@dtoday.net