REGISTRATION FORMSong
of the Grail and the Three Marys Welcome to our Song
of the Grail
and
the Three Marys Pilgrimage in Southern France, May 16 - 26, 2009.
Name as it appears on passport________________________________________________ Name you wish to be called___________________________________________________ Mailing address____________________________________________________________ Home phone_________________________Work phone____________________________ Email______________________________ Website________________________________ Occupation_______________________________ address__________________________ Birth date (month, day, year)_______________Birth time and place__________________ Passport number__________________Date and place of issue_______________________ In case of emergency notify __________________________________________________ Phone_________________________________Relationship_________________________ Special dietary and health needs_______________________________________________ _________________________________________________________________________ Roommate preference_______________________________________________________ (Single Supplement when available is $600). **I have read the Tour Logistics/Tour Responsibility pages and agree to the conditions: Signed__________________________________________ Date____________________________________________
Call
Ani for more information and for registration |