Hajj Registration Form Hajj Registration Form Hajj Registration CHOOSE PACKAGE5 STAR (QUAD) $88005 STAR (TRIPLE) $10.3005 STAR (DOUBLE) $10,8004 STAR (ONLY QUAD) $6800For Triple or Double you must have 3 or 2 people sharing. If you are applying alone then choose the normal Quad sharing packageYour Name Prefix First Last Suffix GenderMaleFemaleDate of Birth Current Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneEmail Enter Email Confirm Email Departure CityWhich City will you be flying from? Departures from Los Angeles and San Francisco are an additional $150. NationalityAre You Travelling with a family member? If yes, write name and relationshipRoommates Please note down the names of the roommates if you are choosing a double or triple roomDEPOSITDeposit of $3000 is required for each passenger to complete registration. Your name will not be registered unless the deposit is received. Make the check out to "CARAVAN 72" and mail it to 7269 COSENZA PL RANCHO CUCAMONGA CA 91701By reading and signing this application you agree that Caravan 72 is not responsible for cancellation or change in flights, hotel accommodations and ground transportation and lost or damaged luggage and health insurance for the duration of the trip. SignatureCopy of passportMarriage CertificateIf you are female under 45 traveling with husband Birth CertificateIf you are a female under 45 or children under 18 traveling with your fatherEmailThis field is for validation purposes and should be left unchanged.