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Today's date:
Name: ______________________________________Citizenship ______DOB:____________
Legal name as it appears on passport (no nicknames)
If you are a geocacher, what is your username?
___________________________
Mailing Address __________________________________________City/State/Zip:_______________________
E-Mail:
__________________________________Tel.__________________________
Cell:________________
Rooming with:
________________________________Tel._______________ Citizenship_________ DOB:
________
If you are a
geocacher, what is your username? ____________________________
Emergency
contact (1st person) ___________________________________________________________________
name relationship telephone
Emergency
contact (2nd person)____________________________________________________________________
name relationship telephone
Land Package: ____ persons@ $1795 (double occupancy) Air
from Newark, NJ: ____ persons@ $895
Single Supplement - $550 (Limited!) ________
Insurance: ____ persons @ $142.00 per person
if double occupancy; $180.00 if single for land package only
Insurance rates with air: Land + Air - Double - Per
Person: $220.00; Land + Air – Single: $258.00
Click here for
more info about the insurance plan.
Deposit: $350 per person
($450 with air) upon reservation.
(Deposit is refundable if reservation cancelled before December 1, 2013.)
Final
Payment due January 8, 2014.
CHECKS MAY BE MADE PAYABLE TO: Traveling Troubadour.
Send to P. O. Box 3189, Staunton, VA 24402
Please charge my credit card
___Visa ___Discover ___Master Card
___American Express
(Note:
We may process your payment through Pay Pal.)
Credit Card #___________________________________________Exp.
Date___________
Cardholder’s name_________________________________
SIGNATURE__________________________________
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