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"Poland, Lithuania & Latvia 2018"Registration Form

[Click Here] for our travel brochure


[Click Here] for a printable tour registration form for mailing instead of using this on-line version

Please submit one form per person.
You may also wish to print a copy of the completed form for your own records.

*  -Required Fields

  Name* (last) *(first)   (middle)
* Please enter EXACTLY as it appears on your Passport
US Passport Number *              Expiration *  mm/dd/yyyy
   
Date of Birth *     mm/dd/yyyy Country of Birth *           
Gender  
Street Address *  
City  *             State * Zip  *           
Phone (Day)*                 - (Evening) -
(Cell) -  (FAX) -
E-Mail *    
Emergency Contact Name & Telephone
Sharing room with Roommate requested  Yes No


The likelihood of us finding you a roommate decreases as time goes by. If a roommate cannot be assigned, you will be notified and you may be billed the single supplement cost...so please send your registration ASAP!
 

Special needs
 Please indicate your performance status: Vocalist Instrumentalist Companion
Voice:S1 S2 A T1 T2 B1B2   Instrument:

Mandatory - Please Check All Appropriate Information

Description No Yes Price
Basic Tour: Land Only, Aug 13-20,2018 (no air)
Early Bird discounts available, see ** below.
 
$1,300
Basic Tour: Single Room Supplement $250
Lithuania & Latvia Extension, Aug 20-25, 2018
Early Bird discount availables, see ** below.
$815
Extension - Single Room supp. $200
       
Optional Excursion 1 (GDANSK): Sopot (Half Day) $35
Optional Excursion 2 (LIDZBARK WARMINSKI): Olsztyn (Full day) $80
Optional Excursion 3 (LIDZBARK WARMINSKI): Frombonk (Full Day) $85
Optional Excursion 4 (VILNIUS: Trakai (Half Day) $45
Optional Excursion 5 (VILNIUS): Dzukija County (Half Day) $60
Optional Excursion 6 (RIGA): Hill of Crosses and Runsdale Palace (Full Day) $85
 

If you register someone who has not traveled with us before, you earn a free optional excursion:

New Traveler Recruited:

Excursion Selected:

Confirm Free Selection:

 

**EARLY BIRD DISCOUNT: Basic Tour reduced to $1,100 and Lithunania and Latvia Extension reduced to $715 if fully paid by April 20. 2018. Early Bird registrants receive priorty on Optional Excursions, and have more likelihood for finding roommates.

Optional Excursions: Please note that these are first come, first served! Extensions are closed when the seats for a particular excursion are filled  They are based on a minimum of 30 paying travelers; otherwise a small group supplement may apply, or the excursion may be cancelled.

Checks: Please make checks payable to: MMG, and write 2018 Poland, Lithuania & Lativia on the memo line. Mail to MMG, Attn: Richard Kuntz, 332 River Bend Road, Great Falls, VA 22066-4140.

 
Credit Card Payments: You may register and pay by credit card at our secure Website: www.medicalmusical.org, click on “Poland, Lithuania & Latvia”. An additional charge of 3% must be added to cover the credit card transaction fee. Pay balance by check or money order to MMG, Attn: Richard Kuntz, 332 River Bend Road, Great Falls, VA 22066-4140.

Sign, Mail Completed Form to: MMG, Attn: Richard Kuntz, 332 River Bend Road, Great Falls, VA 22066-4140. To qualify for the full Early Bird discount, your form and full payment must be postmarked by April 20, 2018 or earlier.

PASSPORT: A VALID PASSPORT IS REQUIRED FOR U.S. CITIZENS. It is recommended that your passport be valid for at least six months from the date of departure. A Tourist Visa is not required for travel to Poland, Lithuania and Latvia, however, your passport should have 2 fully blank Visa pages in it.

IMMUNIZATIONS. Not required, however, the CDC website has a list of recommended vaccinations See http://wwwnc.cdc.gov/travel/destinations/list/.
 
INSURANCE:
The following companies are available but they have no relationship with MMG. They are listed as a service to travelers. Important: Purchase your trip insurance when you make your initial deposit, in order to be covered for preexisting conditions. You may purchase trip insurance from your own home insurance company or from these or any other companies:
 
TRAVELEX: Tel: 1-800-228-9792, www.travelex-insurance.com
TRAVEL INSURED INTERNATIONAL: Tel: 1-800-243-3174, www.travelinsured.com
TRAVEL GUARD
: Tel: 1-800-826-4919, www.travelguard.com

 

Certification

By entering my name, I agree that I have read the above and will abide by all the terms and conditions above in the form.

 


Medical Musical Group is not a government agency.
Last revised: