54.226.61.71
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>100</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>01/17/2015</StartDate>
  <EndDate>07/15/2015</EndDate>
  <DestinationPlan>South Africa</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Elodi</Firstname>
    <Middlename/>
    <Lastname>Schwendener</Lastname>
    <Age>19</Age>
    <Dob>11/22/1995</Dob>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/17/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>24 Hampstead Road</Address1>
      <Address2></Address2>
      <Country>United States</Country>
      <State>Massachusetts</State>
      <City>Jamacian Plain</City>
      <Postcode>02130</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>srepasz@gmail.com</Email>
    <Phone>
      <Home>6177841611</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName></AdDBeneficiaryName>
    <AdDBeneficiaryRelationship></AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147097717470696</CreditcardNumber>
      <NameonCreditcard>Shari R Schwendener</NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>201.96</CreditcardAmount>
      <CreditcardCodeNumber>083</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>