Name ____________________________________________________________________________
Address __________________________________________________________________________
City __________________________________Sate: ____________ ZIP ______________________
Home Tel. # __________________________ Work # _____________________________________
Cell # ________________________________ e-mail: ______________________________________
Website _______________________________Passport Country of issuance_____________________
Passport #______________________ Date of issuance _________ Date of Expiration_____________
Name on passport: _____________________________________ (Needed for arrangements in Peru)
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Emergency contact: Name __________________________ Address _____________________________City: ______________________ Sate: ______ Zip code: ________ Telephone # ________________
Email Address: ______________________________________ for easy contact while traveling.
There will be a contact person in the US who will send updates about our journey. Thank you.
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I am signing up for: Peru Journey April 15-24, 2008
Location: Cusco region, (Sacred Valley and Machu Picchu)
Contact Rev. Nancy at: reiki4u@solinavisions.com or 714-739-5819.
Amount enclosed $______________ Check#_____________ (Please do not mail cash).
Pre-Registration required. Make $500.00 deposit by March 15, 2008,
or full payment $1399.00 - Single supplement add $200.00
Mail to:
Nancy Kimes, 5712 Conifer Drive, La Palma, Ca. 90623… (714) 739-5819
Full payment due 30 days prior to arrival in Lima, Peru.
I am ALSO signing up for the 6-Day Extension Tour - Check here _____
to the Reed Islands Lake Titicaca - April 24-29. Additional moneys will be required for this extension.
50% deposit due NLT March 25, 2008. Full payment = $775.00 plus airfare - Cusco to Puno, on return, Puno to Lima.
Approximate cost for airfare - $100.00 each way. Single supplement add $175.00.
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