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Student Registration & Payment Form
Traveler Information
*Name of Traveler:
*Choose one:
*School or Organization:
*Teacher/Sponsor of Trip:
*Address Line 1:
Address Line 2:Apt. or Suite No.
*City:
*State:
*Zip Code:
*Phone:
*Destination of Trip:
*E-Mail of Parent:
*Occupancy Type
Once a rooming list is submitted,each traveler will be billed on his or her room occupancy which could increase the cost of the trip.
*Number of Travelers on this reservationIf more than 1, list below.
List Additional Travelers & Relationship to Primary Traveler:Ex. Lee Smith - Father
Comments:
Credit/Debit Card Information
Please refer to your registration form for the deposit & payment amounts and also for the payment schedule.
NOTE: A 3.5% fee imposed by the credit card companies will be added to each card transaction.
Once the payment is invoiced, you will receive a receipt via email.
*Amount to charge today:3.5% will be added
*Card Number:Please put dashes between sets
*Name on Card:Please put dashes between sets
*Expiration Month:
*Expiration Year:
*Card Brand:
By submitting this form, you are agreeing to all terms and conditions and no money is refundable or transferable.
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