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For issues or questions with the online registration form, please call the CANDLES Museum at 812.234.7881 or email

Online Trip Registration Form

Dates of Travel: June 30 - July 8th, 2019


  • Send or Upload copy of your PASSPORT to CANDLES Holocaust Museum (upload options at end of form)
  • Send your $750 DEPOSIT to CANDLES Holocaust Museum (payment options at end of form)

Auschwitz 2019 Trip B Registration

This is a secure site.

Each individual should complete and return a separate registration form, a copy of your passport (if you are booking the "complete" trip package), and the nonrefundable $750 deposit. The full payment balance is due no later than March 13, 2019 for all trip packages.

Those booking the "complete" trip package are required to submit a copy of the passport you will be traveling with to CANDLES no later than April 20, 2019.

Guidelines & Responsibilities
Pacing Statement
Registrant's Information
Registrant's Address and Other Contact Information

Those booking the "complete" trip package must provide CANDLES with a copy of the passport you are traveling with no later than April 20, 2019. Failure to submit your passport copy on time will result in penalty fees and may cause you to lose your guaranteed seat on the plane.

Phone Type
Phone Type
How did you hear about the trip? (Mark all that apply.)
Emergency Contact
Personal Considerations
Do you have a food allergy?
Do you have an allergy to animals?
We make every effort to accommodate our guests, but we can only make special requests (beyond meat or vegetarian options) for food allergies and special circumstances.
Meeting Location on Departure Day
Facebook User
Do you use Facebook?
Hotel Accommodations
All rooms are non-smoking. All hotel accommodations are based on availability.
Independent Travel Arrangements:
Travel Plans
Complete this section ONLY if you are purchasing the "land" trip package.
I am traveling to Krakow via:

Summary of Services

Services or products related to travel are listed below. The choice of either the "complete" trip package or the "land" trip package is required. All other options are added at your discretion. An autographed paperback copy of Surviving the Angel of Death is included with both packages.

Trip Package:
Optional Add-Ons:
*Please note: Indiana residents will be charged 7% sales tax on purchased items.
Trip Insurance

Trip insurance is HIGHLY recommended for your own protection and will not be provided unless you select the option for your age group. Trip insurance DOES NOT cover situations of political unrest or your cancellation due to unease with travel warnings.

Trip Insurance Terms
State Insurance Rates and Coverage
Trip Insurance
Important to note: For residents of MT, NY, KS, WA, MD, and PA, please use the state-specific insurance rates listed on the documents above. The rates listed below are intended for the "complete" trip package, not to exceed $4,500, and for residents of states other than MT, NY, KS, WA, MD, and PA.
For those needing a state-specific insurance rate:
Select your state.
*Travel insurance for those in PA must be purchased directly. Please contact Richard Rasch for a price quote at

Payment Information

Please note: A 3% fee will be added to all fees paid using a credit or debit card. This includes but is not limited to services such as PayPal or telephone charges.

Payment Options
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