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 international 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). At least one adoptee must be from Yunnan province.
Number of Adoptees Attending
Other(s) Attending
The family will be responsible for the round-trip airfare of each additional traveler + $1,399 (persons under 12) or $1,899 (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 Yunnan Heritage 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:
- All Traveler’s must Sign and Agree to the CCCWA Terms and Conditions
- All Traveler’s must Sign and Agree to the Legacy Journey Policy & Waiver
- 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.
- 100% payment for trip is due no later than January 15, 2015 at 2pm CST. If payment is not remitted by 2pm CST on January 15, 2015, 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.
- If you cancel your trip for any reason before the January 15, 2015 deadline, you will receive a 75% refund, less the registration fee of $200
- If you cancel your trip ON or AFTER January 15, 2015, there will be no refund.
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