enrollment form

SKI TRIP ENROLLMENT APPLICATION

name:

companion name(s):

departure Airport: MIA -

If we are issuing your airline tickets , we need your date of birth:

name: DOB:

name (for airline ticketing purposes, all names must match ID presented at airport) please ensure that all names are spelled correctly on this form!!

address:city:state:zipcode

Email addresshomephoneworkphone

trip location & date: STEAMBOAT- (MAR. 1-5)

property: SHADOW RUN CONDO

accommodation type: 2BD/2BTH

price: $780 (based on 3 IN 2BD/2BTH)

price includes: Round trip Airfare (MIA/HDN/MIA), ground transfers to and from HDN Airport, 2BD/2BTH - SHADOW RUN CONDO for 4 nights, all taxes

AIRLINE ITINERARY

DL 891T 01MAR MIAATL SS4 630A 830A
DL1218T 01MAR ATLHDN SS4 1015A 1204P
DL1218T 05MAR HDNATL SS4 100P 608P
DL1973T 05MAR ATLMIA SS4 715P 918P

Price subject to increase due to increase in base fare prior to booking, airline taxes , fuel surcharges or airport passenger facility charges. All rates are subject to space availability at time of purchase. Space is limited and is on a first come first serve basis.

requested roommates:if different than companion name(s)

special requests:

CREDIT CARD CHARGE AUTHORIZATION

CREDIT CARD   NAME OF CARDHOLDER

     CARD NUMBER EXPDATE

For your security, American Express and MASTERCARD/VISA have instituted additional security measures for their cards.

AMEX CID                   VISA/MC CW2

(CID)This is a four-digit number that appears on the front of your AMEX card, above your card number.
(CW2)This is a three-digit security code that appears on the back of your MC/VISA card in the signature panel, and at the end of card number.

   INITIAL I understand that the total amount is due in full and the total package price will be charged to my credit card.

payments are non-refundable.

CONFIRMATION WILL BE E-MAILED TO YOU WITHIN 15 DAYS OF RECEIPT OF THIS APPLICATION.

CANCELLATIONS MUST BE MADE IN WRITING. NO REFUNDS WILL BE GIVEN ON UNUSED PORTIONS OF YOUR PACKAGE.

TRAVEL INSURANCE IS RECOMMENDED.

INITIAL---I have read and agreed to the cancellation penalties.

     SUBMIT THIS FORM BY PRESSING THE SUBMIT BUTTON.

               TO ASSURE RECEIPT, YOU MAY ALSO FAX THIS FORM TO

(954) 252-3936