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Hajj Form

Hajj 2025 Pre-Registration Form

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First Name

Last Name

Phone Number

Email

Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Please Choose a prefered Gateway

JFK IAD ORD IAH DFW LAX SFO BOS YYZ YUL LHR SYD PER Other

Have you been for Hajj before ?

Yes No

Which Manasik camp are you Interested in for your Hajj Package ?

Majar Al Kabsh (VIP Camp) Al Moaisim (Noth Ammerican Camp)

Number of Tavelers

Traveler 1

First Name

Last Name

Traveler 1 Date of Birth

Traveler 1 Gender

Male Female

Traveler 1 Email

Traveler 2

First Name

Last Name

Traveler 2 Date of Birth

Traveler 2 Gender

Male Female

Traveler 2 Email

Traveler 3

First Name

Last Name

Traveler 3 Date of Birth

Traveler 3 Gender

Male Female

Traveler 3 Email

Traveler 4

First Name

Last Name

Traveler 4 Date of Birth

Traveler 4 Gender

Male Female

Traveler 4 Email

Traveler 5

First Name

Last Name

Traveler 5 Date of Birth

Traveler 5 Gender

Male Female

Traveler 5 Email

Do You Have any Physical Disabilities and/or Health conditions we should be aware of ?

Yes No

What is your First Language ?

What is the name of your Local Masjid ?

Additional Comments or Notes

Contact Info

28695 Ryan Rd Warren MI, 48092
Phone:(586) 578-9126
Email: fly@amitytravel.net

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