Please read carefully and fill up the following form.
1. Personal Details
Mrs Given Name (s): Fathers Name: Postal Address:
Family Name: Mothers Name:
Phone Number *
Please tick preferred contact number
3. Are you legally entitled to live in Australia?
Yes, I am an Australian or permanent resident
No, I am not
Yes, I hold a vaild Visa Passport Number:
Expiry Date: Issue Date:
5. Please state occupation
3. Do you Smoke?
4. Are you currently employed?
Yes (Go to Q5)
6. Please Specify your destination:
Add other destinations
7. Do you suffer from any serious illness?
Yes, Please specify
8. Are you accompanying anyone with you on this Hajj Trip?
Yes, Please specify their names
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 (costing $6,800) includes my:
9. (For Females) What's the name of your Mahram? Please Read Carefully
1. 2. 3.
4. 5. 6. 7.
Hajj visa/permit to enter the Hajj Precincts of Saudi Arabia; Hajj service and transport fee (Mutaweff fee) in Saudi Arabia; Return airline tickets (with either Emirates or Etihad Airlines) from Australia to Saudi Arabia and back (where I further acknowledge that a minimum of $200 will apply for any further destination); Hajj sacrifice fee (Od’Heyiah); Meals in Mina and on the day of Arafa’t; 10 liters of ZamZam water; 8 days (8 nights) accommodation in Medina’s AlDeyar International Hotel (where I further acknowledge and agree to share my room/accommodation with either of 3 to 4 other individuals) with daily open buffet for breakfast; 8 days (7 nights) accommodation in Mecca’s Zamzam Hotel (where I further acknowledge and agree to share my room/accommodation with 3 to 4 other individuals); 10 days (10 nights) accommodation (End of the Hajj) in an apartment in Shisha/Azizia (Suburban Mecca) (where I further acknowledge and agree to share my room/
accommodation with 4 to 5 other individuals and my toilet/bathroom between 9 other individuals); 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 and that the Zamzam Hajj Group will not be held liable in this respect. Pay a deposit of 25% to se-
cure my booking and visa.
WARNING: A cancellation fee of an amount equivalent to the deposit is applicable in the event that I cancel this agreement.
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.