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China Winter Tour - Children Traveling w/Parent(s)

This form is for children who will be accompanied by their parent(s). There is a non-refundable $100 application processing fee.

TRIP FEE SCHEDULE (per person):

China-born Children = Responsible for cost of round-trip airfare to and from Beijing

Parents and Siblings (12+ years) = Responsible for cost of round-trip airfare to and from Beijing + $1,799 per person to cover hotel and travel expenses once in China

Siblings (under 12) = Responsible for cost of round-trip airfare to and from Beijing + $1,499 per person to cover hotel and travel expenses once in China

Parent Personal Data

Parents will be responsible for their round-trip airfare + $1,799 per parent to cover hotel and travel expenses once in China.
Name * First Last
Relationship
Occupation

(i.e. doctor, lawyer, social worker, etc.)
Name First Last
Relationship
Occupation

(i.e. doctor, lawyer, social worker, etc.)
China-born Children Attending

The China Center for Children's Welfare and Adoption (CCCWA) will cover the costs of the trip, excluding airfare to and from Beijing, for children born in and adopted from China.
Number of Children Adopted from China Attending
Name (Child 1) First Last
Name (Child 2) First Last
Name (Child 3) First Last
Name (Child 4) First Last
Other Siblings Attending

Parents will be responsible for the round-trip airfare of each sibling + $1,499 (siblings under 12)/$1,799 (siblings 12 and older) per sibling to cover hotel and travel expenses once in China.
Number of Other Siblings Attending (under 12 years old)
Name (Child 1) First Last
Name (Child 1) First Last
Name (Child 2) First Last
Number of Other Siblings Attending (12+ years old)
Name (Child 1) First Last
Name (Child 1) First Last
Name (Child 2) First Last
Emergency Contact (someone not traveling with you)
Primary Contact's Name * First Last
Relationship *
Phone Number * ### - ### - ####
Email
Secondary Contact's Name First Last
Relationship
Phone Number ### - ### - ####
Email
Statement from Parents or Guardians:

I have read the above and have a good understanding of the proposed Heritage Winter China 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 * MM / DD / YYYY
Parent or Guardian:
Today's Date MM / DD / YYYY
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number * ### - ### - ####
Email (Confirmation will be sent to this address) *
Application Processing Fee Payment Information

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Parent Personal Data

China-born Children Attending

Other Siblings Attending

Emergency Contact (someone not traveling with you)

Statement from Parents or Guardians:

Application Processing Fee Payment Information