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):
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.
