LegacyJourney


Adult(s) Information

Adults will be responsible for their round-trip airfare + $2,099 per parent to cover the costs of standard tour + extended tour cost per person (if applicable)

Number of Adults Attending


Name*


First


Middle


Last

Date of Birth*


MM/DD/YYYY

Passport*


Number                Expires


Gender


Relationship


Adoptee(s) Information

The China Center for Children’s Welfare and Adoption (CCCWA) will cover the costs of the standard tour, excluding airfare to and from Children, for children born in and adopted from China. The family will be responsible for extended tour cost per person (if applicable).


Number of Adoptees Attending



Other(s) Attending

The family will be responsible for the round-trip airfare of each additional traveler + $1,599 (persons under 12) or $2,099 (persons 12 and older) per traveler to cover the costs of standard tour + extended tour cost per traveler (if applicable).


Number of Other Travelers Attending (under 12 years old)


Number of Other Travelers Attending (12+ years old)



Emergency Contact (someone not traveling with you)

Primary Contact’s Name*

Relationship*

Phone Number*

Email



Secondary Contact’s Name

Relationship

Phone Number

Email


How did you hear about us?

Reference Name:


Statement from Parents or Guardians:

I have read and understood the above information on the CCCWA Sponsored Summer 2019 Tour and the costs associated. I am confirming that the information provided is true and accurate.


Parent or Guardian:*


Please enter your full name and the date you are submitting the application.


Today’s Date*

Parent or Guardian:


Please enter your full name and the date you are submitting the application.

Today’s Date

Address*


Street



City



State / Province / Region



Postal / Zip Code



Country

Phone Number*

Email (Confirmation will be sent to this address)*


Application Processing Fee Payment Information

Once you click submit, we will only process the $200 application processing fee.


Total Amount*

Name on Card*


First


Last

Type of Card

Card Number*

Expiration Date*

 

Security Code (CCV)*

Card Holder’s Signature*

Billing Address*



Street


City


State / Province / Region


Postal / Zip Code

Billing Phone


By checking this box,
I agree to the following terms and conditions:

  1. All Traveler’s must Sign and Agree to the CCCWA Terms and Conditions
  2. All Traveler’s must Sign and Agree to the Legacy Journey Policy & Waiver
  3. A non-refundable registration fee of $200 will serve as a deposit per family that must be paid at the time of registration. Note: the deposit amount goes toward the total trip amount.
  4. 100% payment for trip is due no later than March 31, 2019 at 2pm CST. If payment is not remitted by 2pm CST on March 31, 2019, there will be a 3% charge added to your total amount. There are no exceptions. All fees for travel must be paid at this time or the reservations and flights for your trip will not be able to be finalized.
  5. If you cancel your trip or you are not able to travel for any reason before the March 31, 2019 deadline, you will receive a 75% refund, less the registration fee of $200
  6. If you cancel your trip or you are not able to travel for any reason prior to May 1, 2019, you will receive a 50% refund, less the registration fee of $200. If you cancel your trip or you are not able to travel for any reason ON or AFTER May 1, 2019, there will be no refund.