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Middle Earth Adventure
Registration Form
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Please fill out this form!
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First Name:
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Last Name:
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E-Mail:
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Address:
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City:
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State:
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ZIP:
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Country:
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Phone:
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Preferred Adventure:
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28 February - 4 March, 2008
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13 March - 18 March, 2008
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In case your preferred Adventure is filled
or cancelled:
Are you flexible on dates?
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Payment
Method:
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Check
Credit
Card
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Payment
options:
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Deposit
US $ 500
Balance
in full
Balance
in 4 subsequent payments (incl. US $
25 admin fee)
Full
Amount
Full
Amount (Extra: additional coaching session
after Adventure (US $ 125) |
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Based
on your payment choice we will send
you an appropriate invoice. |
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Comments:
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Your comments
or questions here!
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I
have read the Payment &
Cancellation Policy |
Payment & Cancellation
Policy
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