123456 Hajj and Ummrah Application Form Thank you for expressing interest in applying to attend with the UMA | ZamZam Hajj group. Please fill out the below online application form and one of our friendly ZamZam Hajj staff will get in touch with you soon. Step 1: Personal Details Title: MrMrsMsMissDrOther Given name(s): Family name: Applying For: HajjUmrahBoth Package: StandardAdvanced Step 2: Contact Details Prefered Contact: HomeWorkMobile Home: Work: Mobile: Email: Step 3: Emergency Contact Details Contact Name: Contact Relation: Contact number: Contact Email: Step 4: Postal Address Street Number: Street Name: Suburb: City: State: New South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern AustraliaAustralian Capital TerritoryNorthern Territory Post Code: Country: Step 5: Citizen Status Are you an Australian Citizen? YesNo Do you have a valid visa? YesNo Visa Type: Visa Expiry: Passport Number: Passport Issue Date: Passport Expiry Date: Passport Issued At: Step 6: Other Information Are you currently employed? YesNo State Occupation? Do you smoke? YesNo Do you suffer from serious illness? YesNo State Illness? Please Specify your destination(s): Sydney-Hajj-Sydney Other Destinations(s): Other Will you be traveling with company? YesNo Partner Name: Relation: Females (Must Travel With Mahram): Agreement Terms & Conditions (Please read carefully) I acknowledge and agree that the following terms and conditions form part of my contract with the Zamzam Hajj Group in the provision of the Hajj Services to Saudi Arabia. Furthermore, I acknowledge and agree that my Hajj Package includes my: Hajj visa/permit to enter the Hajj Precincts of Saudi Arabia Hajj Services and transport fee (Muttaweff fee) in Saudi Arabia Return airline tickets from Australia to Saudi Arabia and back (I further acknowledge an additional fee will apply for any other destination and a $200 fee if I choose to book my own flights) Strictly no changes will be made to room allocations once finalised. Any requests must be made to ZamZam admin before departure from Sydney Hajj sacrifice fee (Od'Heyiah) All flights are booked as a group booking through the airline. Any seat or upgrade must be done upon check in at the airport at your cost Meals in Mina and on the day of Arafa't 6 days (5 nights) accommodation in Medina (where I further acknowledge and agree to share my room/accommodation with 3 or 4 other individuals) with daily open buffet breakfast and Dinner. 12 days (11 nights) accommodation in (where I further acknowledge and agree to share my room/accommodation with 3 or 4 other individuals) with daily open buffet breakfast and Dinner. Photos of Zam Zam Hajj group will be posted on social media: please advise the group if you do not wish for your photo to be posted. I understand that if I have been to Hajj in the past 5 years there will be a surcharge fee of $2000 riyals I understand that due to our strict guide-to-hajj ratio policy, we are unable to accommodate anyone with special ability needs and requirements I agree to abide by the following: I will at all times respect and care for my fellow Haji's whether in my rooms in Mecca/Medina (without complaint) I also agree to follow any and all instructions given by the hajj organisers and guides I will not be abusive or disrespectful to anyone specially the Zamzam Hajj Group organisers I am responsible for any of my lost property, and I understand that ZamZam Hajj Group will not be held liable in this respect. I will pay a deposit of $5000 to secure my booking and visa. I understand that submitting this form is subject to the ZamZam Hajj group admin approval PLEASE NOTE: In the event that I choose to cancel this application I will forfeit any moneys paid towards the Hajj trip. I understand that, once my flights or accommodation is booked, ZamZam Hajj Group will take NO responsibility if I choose to cancel the trip. I will forfeit the cost of any items booked (once visa has been booked and you wish to cancel, all money’s paid will be forfeited) I understand that providing false information or withholding information relevant to my application with the Zamzam Hajj Group may result in the withdrawal or termination of the contract. “Accepted Hajj has no reward but Paradise” (Al-Bukhari and Muslim)