Registration Form for the May 13-15, 2005

Please complete the following booking form in order to request a reservation.  A SEPARATE FORM MUST BE COMPLETED BY EACH PERSON ON THE RESERVATION if not married.  As with all group trips offered on this site, each person attending must meet the criteria as stated in our REQUIREMENTS page before signing up for a group trip. There must be at least ONE person in the room that is at least 21 years of age, and will be responsible for all minors in the room.

Full Name

Age

Address 1

Apt/ Suite/ No.

City, State & Zip

Home Telephone

Work or Cell Phone

E-Mail Address (required)

Congregation Name & City

PO Name

How were you referred to us?

Select YES NO

Have you traveled with us before?

Please indicate here whether you are traveling alone or with other roommates (if not traveling with your spouse, WE REQUIRE EACH PERSON TO COMPLETE A REGISTRATION FORM.  Thank You.)

If traveling with others, please list your roommate's information here

Name

Phone

Age

E-Mail

Select One We will be driving We require BUS Transportation Not Sure Yet

How will you be arriving to the Pinegrove Ranch / Means of Transportation?

If you have any additional comments, or special requirements (i.e., handicapped, senior citizen, etc.), please offer them here:

REMINDER: Reservations cannot be confirmed without the required deposit as stated on the Trip Page. The minimum required deposit MUST be received in our office within 2 WEEKS of submitting this registration, or reservation will be cancelled! How do you plan on sending in your payment for this trip?

Select One Check Money Order Credit Card (3% fee applies)

If you plan on paying by credit card:  please note the following:  A 3% handling fee will be assessed to all credit card payments.  Also, in order to protect your privacy and credit card information, we will contact you verbally to process this transaction.

Before you submit this form, please make sure you have entered all contact information correctly.  You will be contacted via e-mail shortly upon receipt of your booking form.  If you have not received a reply in over 24 hours, you should contact us immediately.

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