Peru-Spiritual-Tour-Registration-Form

Peru-Bolivia Spiritual Tour

11th – 30th August, 2012

Registration Form

 

SURNAME:          ____________________________________________

FRIST NAMES:    ____________________________________________   (as on passport)

PASSPORT NUMBER,  _________________________________________

COUNTRY OF ORIGIN _________________________________________

 EXPIRY DATE:               _______________________________________

DATE OF BIRTH    _____________________________________________ 

ADDRESS____________________________________________________________________

City            _____________________________________

 State         _____________________________________

Post Code   ____________________________________

Country    _____________________________________

Day Phone    ___________________________________

Mobile/Cell phone _____________________________

Fax or Email  __________________________________ 

MEDICAL CONDITIONS

________________________________________________________________________________

MEDICATION                   

________________________________________________________________________________

PLEASE TICK AND COMPLETE THE FOLLOWING INFORMATION WHERE APPLICABLE:

OPTION ONE (FULL TOUR) – 11TH – 30TH AUGUST

(         )   TWIN OCCUPANCY  $3950 USD           

(        )    SINGLE OCCUPANCY   $4650 USD

 

OPTION TWO  – 16TH – 30TH AUGUST

(        )    TWIN OCCUPANCY $3300 USD             

(        )    SINGLE OCCUPANCY   $3825 USD

  

PAYMENT OF DEPOSIT $100 USD      (       ) BY CREDIT CARD 

CREDIT CARD DETAILS:    ____________/ ____________/ ____________/ ____________

(12 digit card number) 

CARDHOLDER NAME       __________________________________________________

(as appears on your card)

EXPIRY DATE _______________  SIGNATURE  ________________________________

 OR

PAYMENT  OF DEPOSIT $1000 USD   (       ) BY DIRECT BANK CREDIT TO: 

SHENESTAR CREATIONS NO. 2 ACCOUNT

BANK:                                    Bank of Queensland

BSB Number:                        124001

ACCOUNT Number:             21632009

(please place  your name and ‘Peru deposit’ in the reference)

 OR  PAYMENT OF DEPOSIT $1000 USD via PAYPAL (see below):

 


Spiritual Tour – Peru




PLEASE NOTE THAT AMOUNTS ARE IN U.S. DOLLARS.   IF YOU REQUIRE ASSISTANCE WITH EXCHANGE RATES /BANK TRANSFERS PLEASE CONTACT US.

PLEASE CHECK AND TICK THE FOLLOWING:

(       )  I am vegetarian       (       ) I am a smoker

 

If you wish us to arrange a taxi for you to ‘Paz y Luz’ in the Sacred Valley direct from Cusco airport on your arrival please detail the following: 

DATE OF ARRIVAL; AIRLINE & FLIGHT NUMBER

______________________________________________________________________  

DATE OF DEPARTURE; AIRLINE & FLIGHT NUMBER FROM LA PAZ, BOLIVIA

_______________________________________________________________________________

WHAT IS INCLUDED: 

Taxi from Cusco Airport to ‘Paz y Luz’, Pisac in Sacred Valley.

Group transportation whilst on tour 11th to 30th August.

Entrance fees

Accommodation in hotels 3*** or above

Daily breakfast and several lunches/dinners 

Expert English speaking guides on Andean culture

Meditations and ceremonies

WHAT IS EXCLUDED:

International and local flights

Meals where not indicated

Drinks,

Entry & Exit Visas/fees and airport taxes – it is imperative that you check for visa requirements

Passports – please check on regulations with expiry dates

Travel and personal health insurance

Tips and donations

Personal expenses, eg personal laundry, drinking water, telephone calls

All else not mentioned

PAYMENT SCHEDULE

$1000 USD deposit required  by 16th March, 2012 to secure your place. 

Balance of payment is due on or before 1st July, 2012.

(if you require us to assist you with a payment plan please contact us)

CANCELLATION POLICY:

All cancellations on or after 16th March will incur loss of $1000 deposit.

All cancellations on or after 1st July will incur loss of all monies paid.

WAIVER

I/we agree to take responsibility for all blessings and challenges that can happen in a third world country.  I/we agree to release Victoria and David Webby, Shenestar Creations and associated travel companies and providers from all responsibility and liability or unforeseen circumstances and/or changes in the schedule due to acts of God (weather, earthquakes etc), acts of terrorism and political policy and unrest and any other unforeseen events or mental/physical illnesses occurring during tour dates.  I/we understand that Victoria and David Webby, Shenestar Creations and associated travel companies and providers reserve the right to ask a group member to leave the tour if their behavior is harmful, disruptive or dangerous to the tour group.  I/we understand that I/we are aware of and agree to the registration payment and cancellation policies and understand and agree to all of the above information.

Person 1: 

NAME ________________________________________________

SIGNATURE ___________________________________________

DATE  _______________________________________________

Person 2: 

NAME ________________________________________________

SIGNATURE ___________________________________________

DATE _______________________________________________

FLIGHT PLANS/INSURANCES/VISAS

If you have no travel service in mind, we recommend Nilla from Albany Travel.  Her email is:  nilla@travelwithjetset.com

Nilla is very intuitive and a warm, lovely person. and has assisted us with other travel arrangements.

 

 


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