Secure Payment Form

Booking Form

Traveler's Data
If you travel in group our with your family, enter the data of the group leader or family head. All spaces must be completed.

Names and Surnames:

Telephone:

E-mail:

Complete Address:
(address, city, zip code, country)

Cardholder's Data
All spaces must be completed. Enter the data according to the information appearing in your credit card and Billing address.

Cardholder's Name as on card:

Street Address :

City + Zip Code:

State/Province/County:

Zip Code :

Enter "99999" if outside the USA

Country:

Email:

Tour Booking and Registration
Enter the number of participants that you will reserve or register and choose the month in which you would like to make the trip. Please make the two additional payments for Booking no later than 30 days before the Tour begins.

Booking and Registration payments per Participant		Number of Participants	Month in which you will be traveling
.Booking:	US$ 500
.1st registration .payment:	US$ 1,625
.2nd registration .payment:	US$ 1,625
Total:	US$ 3,750

Notes: • Your credit card will be charged the payment amount multiplicated by the number of participants entered (e.g.: Booking of US$500 x 2 participants = US$ 1,000). • Just add amounts in the fields under "number of participants" that correspond to the payment you want to make. The fields you do not want to pay must show "cero"(0).

In the next page you will enter your card details on a secure server

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