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Concordia Moorhead Fan Registration Form

Name(Required)

First Middle Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Passport Number

Passport Exp. Date

Passport Country

Date of Birth

Select Trip Package

Payment Options(Required)

Pay in Full - $5495 (due March 15, 2027)

Pay Minimum Deposit - $2,000 (due upon registration)

Payment Options(Required)

Pay in Full - $3,925 per person (due March 15, 2027)

Pay Minimum Deposit - $2,000 / per person (due upon registration)

Name (Second Traveler)(Required)

First Middle Last

Email (Second Traveler)(Required)

Passport Number (Second Traveler)

Passport Exp. Date (Second Traveler)

Passport Country (Second Traveler)

Date of Birth (Second Traveler)

Trip Cancellation Insurance (One Person Package)(Required)

Trip Cancellation Insurance (Two Person Package)(Required)

Trip Cancellation Insurance Cost:

$79 One Person Package / $158 Two Person Package
Of the total per person deposit, $1,000 per person is non-refundable and not included in the calculations for refund.
Cancellations WITH trip cancellation insurance purchased:
90 days or more prior to departure: 100% of tour cost refunded
60-89 days prior to departure: 50% of tour cost refunded
30-59 days prior to departure: 25% of tour cost refunded
Less than 30 days prior to departure: no refund

Total

Credit Card

Cardholder Name

Card Details

Create a password to complete your trip profile. Your username will automatically be your email address used above. If you purchase a two person package the account will be created with the first traveler's information.

Password

Enter Password Confirm Password

Your J5 Inc. User Account

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Join the Dragons in

ITALY

Concordia Moorhead Fan Registration Form

Trip Cancellation Insurance Cost:

Your J5 Inc. User Account

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