34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>06/13/2017</StartDate>
  <EndDate>06/28/2017</EndDate>
  <DestinationPlan>Costa Rica</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Lily </Firstname>
    <Middlename>M</Middlename>
    <Lastname>Silveira</Lastname>
    <Age>16</Age>
    <Dob>12/16/2000</Dob>
    <Gender>Female</Gender>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>06/13/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>507 Cedar St</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Pacific Grove</City>
      <Postcode>93950</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>3luvs98lcp@gmail.com</Email>
    <Phone>
      <Home>8315211648</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5178690545344528</CreditcardNumber>
      <NameonCreditcard>Jeannette Silveira</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>19.76</CreditcardAmount>
      <CreditcardCodeNumber>561</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>