Registration form
I wish to reserve my place on the following tour:
Aroma Camp Tour
early Registration 10% discount
Name:_________________________________________________________
Address:_______________________________________________________
State:____________ Zip:_________________ Country:__________________
Phone: Office:______________ Home:______________
Fax:_____________e.mail________________________
___Male ___Female
Occupation:________________________________________
Passport Number:___________________Country of Issue:____________Expires:_______
Special requirements: (Diet, food, etc be
specific)_______________________________________________
Special medication/prescription drugs _________________ Impairments
ie. walking, hiking, visual________
(For each person in your party please make a copy of this sheet and fill out
the details listed.)
How did you hear about AromaCamp:_____________________________________________
___ I enclose a non refundable check of $ 1,000. US$ as a reservation
____I enclose the full amount of $2,700.00 before the deadline of ____ 2006 ( pre-payment discount)
____I enclose the full amount of $2,900.00 after the date of ____
MC/Visa Discover Name on card:____________________________________
| MC/Visa #:__________ __________ _________ _________ | Exp. Date:___ /___ /___ |
| Signature: | Date |
Return this registration form after reading the Booking form agreement along with your check / money order / MC / Visa / American Express Make checks payable to Victoria Edwards (AIR is a Educational organization) Purchasing Travelers or trip Insurance is highly suggested.
and send to:
 |
AromaCamp 2006 Aromatherapy Institute &
Research |