ASSYAKIRIN MOSQUE MANAGEMENT BOARD

REGISTRATION FORM Please attach

8th ISLAMIC CIVILISATION TOUR recent
passport
10D/8N ITALY : SICILY & ROME photo
S$ 3,985* (FULL BOARD)
25 November - 4 December 2017 *For 1st 20 participants
FOR OFFICIAL USE:
Registration No. PAID/ NOT PAID AMOUNT : $
*CASH/NETS/CHEQUE NUMBER:
Date: RECEIPT NO: DATE:
NAME OF ISSUING OFFICER:

ACCOMPANYING FAMILY MEMBERS : FATHER/MOTHER/ HUSBAND/WIFE/

DAUGHTER/SON/BROTHER/SISTER
Total No:
* please fill up a separate form for each participant

REQUIRED COPIES OF THE FOLLOWING DOCUMENTS:

NRIC/BC & PASSPORT MEDICAL RECORDS/ PRESCRIPTIONS
PARENTAL/GUARDIAN LETTER OF CONSENT (FOR INDIVIDUALS BELOW 21)
DIETARY/ALLERY NOTIFICATIONS
VACCINATION: MENINGITIS / INFLUENZA

NAME (AS PRINTED IN PASSPORT):

ADDRESS: APT BLK UNIT #

SINGAPORE

OCCUPATION: TEL: (H)

(O)

EMAIL: H/P

DATE OF BIRTH: / / NRIC NO. S /

AGE:

PLACE OF BIRTH : NATIONALITY:

INTERNATIONAL PASSPORT NO:

DATE & PLACE OF ISSUE
PASSPORT EXPIRY DATE
* IN CASE OF EMERGENCY, PLEASE CONTACT
NAME OF NEXT OF KIN RELATIONSHIP CONTACT NUMBER
1)
2)
 ASSYAKIRIN MOSQUE 8th ISLAMIC CIVILISATION TOUR TO ITALY:
SICILY & ROME: 25 NOV - 4 DEC 2017 (10D/8N)

FLIGHT SCHEDULE:-

DEPARTING:
EY 473 25 Nov Singapore-Abu Dhabi :19:20 -23:00 (Operated by Etihad Airways)
EY 2811 26 Nov Abu Dhabi-Rome : 02:25-06:20 (Operated by Alitalia ) AZ 853
EY 2968 26 Nov Rome-Palermo: 10.00-11:10 (Operated by Alitalia ) AZ 1785

INTER-CITY FLIGHT:
AZ 1724 01 Dec Catania-Rome: 12:00-13:20 (Operated by Alitalia)

RETURNING:
EY 2812 03 Dec Rome-Abu Dhabi: 10:40-19:30 (Operated by Alitalia ) AZ 852
EY 470 03 Dec Abu Dhabi-Singapore: 22:50-10:05+1 04 Dec (Operated by Etihad Airways)

BRIEF TOUR ITINERARY:

DAY 1 PALERMO
Palermo discovery tour, one of the major cities of Italy, and the historical and administrative capital
of Sicily. Palermo was conquered in 831 by the Islamic Empire from North Africa and became the
capital of the Muslim Emirate of Sicily until 1072almost 300 years

DAY 2 PALERMO - TRAPANI - MONREALE - PALERMO

Morning tour to Trapani, the Islamic Empire called Trapani Itrabinis, Tarabanis, Trapanesch and their
presence significantly marked the town: in architecture, agriculture, art, language and culture. Tour
through the beautiful City of Monreale. Visit of the Muslim Arab - Norman Duomo of Monreale, an
ancient historical Islamic Mosque converted to a Cathedral after the fall of the Islamic
Empire. Overnight in Palermo.

DAY 3 PALERMO - CEFALU - ENNA

Panoramic Tour through the beautiful Sicilian landscapes which is rich of the Islamic History and
Muslim roots. The tour includes Cathedral & Dome Square of Cefal. Transfer & overnight in Enna.

DAY 4 ENNA - AGRIGENTO - REALMONTE - ENNA

Day trip to Agrigento, Visit the famous Valle dei Templi, an archaeological site in Sicily, The area was
included in the UNESCO Heritage Site list in 1997. Visit the "Scala dei Turchi" or "Stairway of the Turks"
in English, is a very beautiful and extensive rocky cliff overlooking the sea, which is located in
Realmonte. They say that the name comes from the ancient Saracen pirate raids and Muslim Empire,
that protected their wind-powered boats amid these cliffs.. Overnight in Enna.

DAY 5 ENNA - TAORMINA - CATANIA

Morning Tour to Taormina is a commune and small town on the east coast of Island of Sicily, has been
a very popular tourist destination since the 19th century. Panoramic tour, visit Greek theater and the
Muslim Arab-Norman Castle of Monte Tauro. Overnight in Catania.

DAY 6 CATANIA - ROME (by flight)

After arrival, Visit to The Great Mosque and Islamic Centre of Rome. Overnight in Rome.

DAY 7 ROME
After breakfast, Visit the ancient Rome, Panoramic walk tour of Rome , the Colosseum - Foro Romano
- Altare della Patria, Piazza Venezia. After lunch free time for shopping in Rome. Overnight in Rome

DAY 8 ROME AIRPORT

After breakfast, Transfer to Rome International Airport for your return flight.

A S S Y A K I R I N M O S Q U E | 5 5 0 Y U N G A N R O A D S 6 1 8 6 1 7 T E L : 6 2 6 8 1 8 4 6 8th ICC TOUR ITALY '17

F A X : 6 2 6 8 9 7 2 5 | w w w . a s s y a k i r i n . s g | a s s y a k i r i n @ a s s y a k i r i n . m o s q u e . o r g . s g
 ASSYAKIRIN MOSQUE 8th ISLAMIC CIVILISATION TOUR TO ITALY:
SICILY & ROME: 25 NOV - 4 DEC 2017 (10D/8N)

TERMS & CONDITIONS OF ACCEPTANCE

The above tour package price is based on the following services:

a. 3 flights (Singapore-Palermo, Catania-Rome, Rome-Singapore) operated by Etihad
Airways and Alitalia (inclusive YQ and current airport tax at SGD 210)
b. Meet and assist at the Airport (Arriving & Departure)
c. Accommodation in 4**** hotel groups in Italy based on double occupancy
d. Private transportation
e. 24 hours full religious and personal assistance.
f. Personal and group security during the journey.
g. Assistance and serviced journey with a senior staff and local Islamic bilingual staff during
the journey and stay.
h. Tax free refund assistance during shopping and reclaim at the airport.
i. Praying at local mosques if required during the journey.
j. Visits to all the Religious & Cultural city Highlights
k. Maqaams and Mosque visits..
l. Private Islamic Official Guide throughout the Tour.
m. Full board Exclusive Certified Halal Meal Arrangements throughout the Tour.
n. Prayer facilities at all of our 4**** Hotels

The package excludes:

Price does not include beverages, Tips, expenses of personal nature and personal travel insurance.
Tips guideline is 6 EUROS (SGD 10) per person a day. It does not include increase in airport tax of
above SGD 210.

ACCOMODATION IN HOTELS
Palermo: Ibis Style Palermo **** or similar
Enna: Federico II Palace **** or similar
Catania: Four Points by Sheraton **** or similar
Rome: Ih Hotel Z3 Rome **** or similar

PAYMENT
Full payment of $3,985 are to be made by 30 September 2017.
A non-refundable deposit of SDG 800 per person is required at the time of booking.

TRAVEL INSURANCE
We strongly recommend that your purchase a more Comprehensive Travel Insurance Policy to
cover possible cancellation due to medical or compassionate reasons, medical fees, loss of
personal baggage etc as outlined in the Policy. You may opt to buy your own travel insurance
personally or purchase as a group with Assyakirin Mosque.

PASSPORT
Please ensure that your passport has a validity of more than six months from day of return and visa
(if required), for the country to be visited. Please forward your passport to us as early as possible
for visa applications.

ADMINISTRATIVE/ AMENDMENT FEE ( Flight amendment )

A handling fee of S$200.00 per person per amendment will be charged for any alternation upon
confirmation. In addition, an Administrative Fee of minimum $75 per person (subject to Airlines
Fare Conditions) will be charged upon issuance of tickets.

REFUND OF UNUSED SERVICES

No refunds or exchange can be made in respect of Accommodation, Meals, Sight-seeing Tours,
Transport or any other services which are included in the tour fares but not utilized by the tour
member.

EXTENSION OF UNUSED SERVICES

The passenger may extend his/her stay at the end of tour to maximum validity and restrictions of
the air-ticket, seat confirmation and availability of hotel prior to commencement of tour. It is the

A S S Y A K I R I N M O S Q U E | 5 5 0 Y U N G A N R O A D S 6 1 8 6 1 7 T E L : 6 2 6 8 1 8 4 6 8th ICC TOUR ITALY '17

F A X : 6 2 6 8 9 7 2 5 | w w w . a s s y a k i r i n . s g | a s s y a k i r i n @ a s s y a k i r i n . m o s q u e . o r g . s g
 ASSYAKIRIN MOSQUE 8th ISLAMIC CIVILISATION TOUR TO ITALY:
SICILY & ROME: 25 NOV - 4 DEC 2017 (10D/8N)

passengers responsibility to hold firm confirmation for his/her return flight. Any additional charge
imposed by the airlines or tour operators will be borne by the passenger. Extension of stay will be
on passengers own expense and transfer to the airport will not be provided.

All passengers are to follow the group schedules back to Singapore. In the event where
passengers request for cancellation of tour arising from unconfirmed return flight extension, he/
she will be subjected to cancellation charges.

ITINERARY CHANGE
Airlines schedules and local conditions may affect accommodation and routings. Should this
occur, Assyakirin Mosque appointed travel agents shall endeavor to substitute arrangement of
similar value.

RIGHT TO REJECT
Assyakirin Mosque reserves the right to cancel/withdraw any itinerary booking made for client.
Assyakirin Mosque also reserves the right to decline acceptance and/or to retain any members
during part of the tour if it appears that such person (s) is likely to endanger the health or safety, or
impair the comfort & enjoyment of others on the tour.

Assyakirin Mosque further reserves the right to cancel any reservations for any reason,
whatsoever, should any carrier, hotel or contractor refuses to allow the person concerned to
participate in the tour.

CANCELLATION RECEIVED IN WRITING

At any time after your booking has been executed, with our written acknowledgement, the
following cancellation charges shall apply:

More than 60 days before departure : 10% of the cost of package fare*

Between 40 - 59 days before departure: 15% of the costs of the package fare*.

Between 30 - 40 days before departure: 30% of the costs of the package fare*.

Between 20 - 30 days before departure: 60% of the costs of the package fare*.

Less than 20 days before departure: 100% of the costs of the package fare*.

* After deducting non-refundable deposit values of $800

Air-ticket which is submitted for refund, the refund value is subject to individual airline terms and
conditions governing the refund policy. All other services not specified as per above, once booking
is confirmed, no cancellation is allowed.

DECLARATION

I, _________________________________________________ (NAME as in NRIC)

of ______________________________ (NRIC No.) have read and understood the
terms and conditions as stated above and agree to abide by the conditions once I have
submitted my application.

________________________________ ___________________
Signature Date

A S S Y A K I R I N M O S Q U E | 5 5 0 Y U N G A N R O A D S 6 1 8 6 1 7 T E L : 6 2 6 8 1 8 4 6 8th ICC TOUR ITALY '17

F A X : 6 2 6 8 9 7 2 5 | w w w . a s s y a k i r i n . s g | a s s y a k i r i n @ a s s y a k i r i n . m o s q u e . o r g . s g
 ASSYAKIRIN MOSQUE 8th ISLAMIC CIVILISATION TOUR TO ITALY:
SICILY & ROME: 25 NOV - 4 DEC 2017 (10D/8N)

INDEMNITY FORM

I, _____________________________________________________________ (name as in
NRIC) of NRIC No. _____________________________ will be participating in Assyakirin Mosque
8th Islamic Civilisation Tour to Italy: Sicily & Rome on 25 Nov - 4 Dec 2017 facilitated by Assyakirin
Mosque Management Board or its agents and or representatives and or Employees.
I am prepared to give certain warranties, indemnities and consents and make certain
acknowledgements relating to my participation in the tour.
AND WHERE it is a condition of my participation in the tour that the said warranties, indemnities,
acknowledgements and consents be recorded in writing and signed by myself.

Please tick the appropriate box below.

 I warrant that I am 21 years of age or older.

 I am under the age of 21 and am assisted herein by ______________________________
my mother/father/ natural guardian (Name as in NRIC) of NRIC _________________________

I hereby voluntarily assume all risks which are associated with the activities and consent to the risk of
any harm which may befall me whilst participating in such activities including bodily injury and death.

I accordingly indemnify that I shall have no claim of whatsoever nature against Assyakirin Mosque
Management Board, agents or other persons contracted to conduct all or part of Assyakirin Mosque
8th Islamic Civilization Tour to Italy: Sicily & Rome (hereinafter referred to as the parties) for any injury,
harm or loss of whatsoever nature which I may suffer whilst participating in the activities even if such
injury, harm or loss is caused by the negligence of any of the parties.

In addition to the exemption from liability detailed above I further agree that none of the parties shall
be liable to me for any delays, postponement, cancellation, injury, harm or loss of whatever nature
suffered by me at any time during the tour (and not only whilst participating in the activities) arising
from any cause whatsoever including but not limited to illness, accident, theft, injury or death. This
exemption from liability shall apply even where the injury, harm or loss referred to above is caused by
the negligence of any of the parties.

SIGNATURE WITNESSED BY (SIGNATURE)

_______________________________ __________________________

ON THIS DAY OF (DATE, DAY & TIME) FULL NAME & NRIC OF WITNESS

_______________________________ ___________________________

A S S Y A K I R I N M O S Q U E | 5 5 0 Y U N G A N R O A D S 6 1 8 6 1 7 T E L : 6 2 6 8 1 8 4 6 8th ICC TOUR ITALY '17

F A X : 6 2 6 8 9 7 2 5 | w w w . a s s y a k i r i n . s g | a s s y a k i r i n @ a s s y a k i r i n . m o s q u e . o r g . s g
 ASSYAKIRIN MOSQUE 8th ISLAMIC CIVILISATION TOUR TO ITALY:
SICILY & ROME: 25 NOV - 4 DEC 2017 (10D/8N)

To be completed for participants below 21 years old

I, the undersigned (full name of parent/natural guardian) ___________________________

hereby warrant that I am the parent/natural guardian of the minor who is the signatory to this
document and whose signature appears above. I further warrant that I am legally competent to assist
him/her in the signing of this agreement and sign this in due assistance hereby ratifying and
confirming what is contained herein.

A S S Y A K I R I N M O S Q U E | 5 5 0 Y U N G A N R O A D S 6 1 8 6 1 7 T E L : 6 2 6 8 1 8 4 6 8th ICC TOUR ITALY '17

F A X : 6 2 6 8 9 7 2 5 | w w w . a s s y a k i r i n . s g | a s s y a k i r i n @ a s s y a k i r i n . m o s q u e . o r g . s g