Trip Registration

		Itinerary Index
				Xpeditions TV

Registration Form
Once completed, please enclose it with appropriate payment and mail it to us. Our address is shown below.

Register me for "The Amazon Experience"

Amazon Jungle - Shamanism
September 10th - 16th, 2006

$1250
Double

$1425
Single

Register me for "Temple of the Ancient Masters"

Cusco - Machu Picchu - Sacred Valley
September 17th - 25th 2006

$1795
Double

$1970
Single

Register me for "Marca Wasi: Mist Shrouded Mystery"

3 Days/ 2 Nights Marca Wasi
September 26th - 28th, 2006

$685
Double

$835
Single

I have read and agreed to the terms and conditions.

Sign here:

Please use a separate form for each passenger
Photo copies of this form are acceptable

Passport Number & Country of Origin
print clearly in black ink

_____________________________________________________________________________

Personal Information

Mrs./ Ms./Mr. ______________________

Phone ________________________

Address ______________________

City __________________________

State ____

Zip ________

Email Address ____________________________________

Date of Birth __ / __ / __

Female

Male

Please try to arrange a roommate for me

Smoking

Non Smoking

I would like a single room ( I understand there is a single supplement fee - see above)

I have already provided $500 to reserve my place

Enclosed is a check for $500 to reserve my place (note: this is for one or all trip options shown above)

Enclosed is $50 for Tips and Airport Taxes per each option choosen above

A NOTE ABOUT TIPS AND TAXES
We require you to prepay this before we depart. With these funds we see that our tour escorts use these funds to handle all baggage handler tipping and required airport taxes. This enables you to relax, knowing that everyone who assists us is being taken care of completely. With your signature below, you are assuring us you have read and completely understood the "Tour Information" section and the" Terms and Conditions" section, and you completely agree with the stated terms and conditions.

We will not accept anyone that has not completely filled out, signed and submitted this application.

A signed application must be received with your deposit to secure your space on this trip.

You are responsible to have a valid up to date passport!

Signature _____________

Date _________________