EHTPS Ireland Registration

REGISTRATION FOR EHTPS  – IRELAND TOUR

October 10 – 18, 2015

Please submit a separate form for each traveler

After you complete and submit this form, you will automatically be re-directed to the Payment Page, with instructions on how to pay by check, money order, credit or debit card. A deposit payment of $350 ($369 credit or debit) is required to reserve your space on this tour.

    NOTE: The name you enter below must be exactly as it appears or will appear on your passport. If you do not have a passport at this time, please submit this form now and provide RMC with your passport information after you receive your passport. Your passport expiry date should be more than six months after the ending date of this tour.

    First Name (required)

    Middle Name (if applicable)

    Last Name (required)

    Passport Number

    Country of Issue (required)

    Passport Issue date

    Passport Expiry date

    Date of Birth (required)

    Country of Birth (required)

    Mailing Address (required)

    City (required)

    State/Province (required)

    ZIP/Postal Code (required)

    Telephone (required)

    Your Email (required)

    I am: FemaleMale

    I have physical limitations that require special attention. I am entering details in the "Optional Message" area below.(Most situations can be accommodated, but we must know beforehand in order to make arrangements, and there may be additional costs.)

    I require a special diet and am entering details in the "Optional Message" area below

    I do not have a roommate and I understand RMC Travel will try to match me with a suitable roommate.

    (Optional) My roommate will be:

    I am requesting single accommodation.

    Optional Message

    I understand that RMC highly recommends the purchase of Trip Cancellation Insurance, and our preferred Insurance provider is Allianz.

    (required) I understand and accept the Terms and Conditions for this program.
    For security, please enter the following characters in the space below: captcha

    After clicking, you will be re-directed to the Payment page, with how to mail in your check or pay securely online.

    If you have already registered and you would like to go to directly the Payment page, please CLICK HERE