SKI TRIP ENROLLMENT APPLICATION-STECKLER
name:
companion name(s):
check here if you will book your own airfare [if you checked this box, leave the next few lines blank and go directly to address line]
departure Airport: - only if you need airfare
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: PARK CITY- (FEB.29-MAR.5)
property: SILVER KING CONDO
accommodation type: 2BD/2BTH W/SPA
price: $780 (based on 4 IN 2BD/2BTH)
price includes: ground transfers to and from SLC Airport, 2BD/2BTH W/SPA - SILVER KING CONDO for 5 nights, all taxes
Airfare additional-approximately $370 additional per person out of PBI TO SLC
AIRLINE ITINERARY
CO1142L 29FEB PBIIAH SS4 600A 752A * CO1126L 29FEB IAHSLC SS4 910A 1135A * CO1423L 05MAR SLCIAH SS4 1246P 449P * CO1060L 05MAR IAHPBI SS4 810P 1135P *
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 SELECT CARD AMEX VISA MASTERCARD DISCOVER 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