Byways & Back Roads of Eire 2011 Registration Form:
Guest #1 __________________________________
(Name as it appears on Passport)
Guest #2 __________________________________
(Name as it appears on Passport)
Guest #3 __________________________________
(Name as it appears on Passport)
Guest #4 __________________________________
(Name as it appears on Passport)
Address: ____________________________________________
City __________ State _______ Zip Code________
Telephone (_____)_____________
Email Address: _____________________________________________
_ Accept _ Decline Travel Insurance for $169 per person
Payment Info:
First call, first confirmed, limited to 22 guests per tour.
Deposit of $350 per person (of which $100 is refundable) is due upon reservation, payable by *check or credit card. Registration deadline and final payment due by check March 01, 2011. Optional Travel Protection Plan available to purchase at time of deposit for $169.
Confirmation and invoice will be mailed and emailed.
___Check ___ Money Order ___ PayPal (send under Personal not Business to avoid extra fees)
* The tour price reflects a 3% discount for check payment. If you wish to pay by Credit Card, the discount will not apply.
Credit Card: _ Visa _ MasterCard _ AmEx _ Discover
Credit Card Number: ______________________
Security Code:______ Expiration date:__________
Total # in Party ____
Amount: $_________
Please make checks payable to: Catherine Devine or Send funds via PayPal to:
Starry Owl Press (starryowldesign@yahoo.com)
Fax or mail the completed form to:
Catherine Devine
c/o Flanagan’s Celtic Corner
222 E Congress St
Tucson, AZ 85701
1-520-623-9779
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