Costa Rica Tour Registration 2011 Name: Address: Zip Code: Phone: Email: We accept credit cards for the tour, not the air fare portion. 1 week tour…….Deposits $300.00CDN non refundable 2 week tour……Deposit $500.00 CND non refundable Why? Because this is Costa Rica’s high season and all rooms and excursions have too be pre booked in advance! Deposits Please indicate how many? # People __________1 week
__________2 week type of accommodation please circle for your second week, a personal quote will be sent to you for your second week Hotel room only Hotel all inclusive condominium sleeps four with swimming pool Extra tour information.
Payment method Cash
Check
Credit Card
Total deposit amount______________________by December 1st 2010‐11‐04 Payment in full by the 15th December 2010 Credit Card #____________________________ Expiration date_______________________ Name on Card_________________________________________________________________________ Signature_____________________________________________________________________
Sacred Quest Tours Emergency Traveler’s information Please complete and return to us by fax to 888‐823‐5418 or email sue@thevioletray.ca Personal data for all travel documents Name: (as it appears on the passport) Tel: Address: Zip code: Date of birth:
Age:
Occupation:
Expiration date:
City and country of birth: Nationality:
Passport number:
Place of issue:
Date of issue:
Medical conditions: Medications: Personal physician name and phone if applicable
Sacred Quest Tours Flight information Please complete this form and return to us by fax to 888‐823‐5418 or email sue@thevioletray.ca Name: Tel: Email: Room mate request:
International flight information Arrival date and Arrival time into Liberia airport Airline: Flight: Arrival time:
Departure Date and time from Liberia airport Airline: Flight: Departure time: