Women’s Health Symposium Registration Form
I agree to pay $ $1,300 for the Women’s Health Symposium and, if desired, an additional $300 for the Travel Extension by July 1, 2019. This payment includes round trip airfare from JFK to Guayaquil, Ecuador, and all other project expenses excluding 1 evening meal offsite, daily purchases such as water, ice cream, etc. and lunch and supper during the travel extension.
I understand that once payment is made, it will be non-refundable. I also understand that AUF now requires that each participant purchase trip cancellation insurance by the registration due date above. Also, Ecuador requires proof of traveler’s accident and medical insurance.
Checks payable to: ADOPTA UNA FAMILIA Inc.
Mail to: Linda Smith at 136 Whiting Lane – W. Hartford, CT 06119
If you pay online there is a 3% service charge
Trip Insurance companies include but are not limited to the following:
AAA, AIG Travel Guard, Allianz, Insuremytrip.com, Roamright.com, and Travelinsurance.com
Additional forms, which may be found at www.auf-ecuador.org/forms include:
· Health form
· Personal Profile
· Liability Waiver
· Copy of Traveler’s Insurance
· Color copy of Passport
· Color copy of Drivers License