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Salsa Bachata Dance Vacation in Mexico 2017
7 Night Registration and Payment - Please fill out for every individual separately
7 Night All-Inclusive August 13 to August 20 - Price per Person
Single 7 Night
  Single Occupancy for 1
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Double 7 Night
  Double Occupancy for 2
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Triple 7 Night
  Triple Occupancy for 3
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Quad 7 Night
  Quad Occupancy for 4
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Child 2 & Under 7 Night
  Child 2 and younger
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Child 3-12 7 Night
  First Child 3 to 12 years old
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Child 3-12 7 Night
  Second Child 3 to 12 years old
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Grand Total:
Personal Information
E-Mail:*

Phone #:*

First Name (as on US Passport):*

Middle Name:

Last Name (as on US Passport):*

Address Line 1:*

Address Line 2:

Rooming with:

Rooming with:

Rooming with:

City:*

State:*

Zip Code:*

Gender:

Date of Birth*

US Passport/GreenCard Expiration Date*

Affiliate Code*

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