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In order to submit this online registration, please fill out the following form and read and agree to the Terms and Conditions.

If your registration was submitted successfully our system will send you an email containing a copy of your registration for your records. 

Sacred Earth Journeys - Secure Area
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Our registration area uses Secure Socket Layers (SSL), an advanced Internet security system, to protect the data you provide. For security purposes, all your registration information (including your name, address and credit card number) is encrypted using a protected server; as a result, your credit card and billing information is secure on its way to processing and approval.

Print Registration and Terms & Conditions  Form

HOW DID YOU HEAR ABOUT US?

 
PARTICIPANT INFORMATION
Name as it appears on your passport
Title:
Given Name(s):
Surname:
Street Address:
City
Country
Province / State
Postal / Zip Code
Date of Birth (M/D/Y)
Place of Birth
Work Phone
Home Phone
Email Address
Please note: We require a unique email address for each person registering. Also, please make sure you enter your email address correctly as this will be the email we send your Registration Form copy to.
     
Passport Information
Passport Number:   Nationality:
 
Date of Issue (M/D/Y):   Place of Issue:
 
Date of Expiry (M/D/Y):   Profession:
 
     
Emergency Contact Information
Name:   Phone: 
 
Email:    
   

SPECIAL DIET
I require a special diet, or the following special services:
No
Yes (Please describe below)

TRAVEL INSURANCE

We strongly recommend purchasing Travel Insurance (Cancellation and Medical Insurance) to protect against cancellation fees and additional travel expenses that may incur before, after or during the trip.

For Canadians, we offer an all-inclusive travel insurance through TIC (Travel Insurance Coordinators), which includes trip cancellation, medical, and other coverage. Cancellation and Medical Insurance can also be purchased separately. Contact us for prices & policy details.

For Americans, we offer Travel Insurance Select through Travel Insurance Services at this link - http://www.travelinsure.com/what/selecthigh.asp?32963.

For citizens of other countries we offer two medical plans (not cancellation) through Travel Insurance Services at these links:

Travel to the USA - http://www.travelinsure.com/what/vusahigh.asp?32963
Travel to other countries - http://www.travelinsure.com/what/wmedhigh.asp?32963.

Please note: A Travel Insurance Waiver Form must be signed, if you do not wish to purchase insurance through us.

Yes, I plan to purchase trip insurance through Sacred Earth Journeys and/or their agents.
   
No, I decline to purchase trip insurance through Sacred Earth Journeys and/or their agents.
   
I will be purchasing trip insurance through my local agent.
   
TOUR EXTENSION (optional)

This tour has an optional extension, entitled Island of the Gods: A Crete Encounter. It will begin on the last day of the tour (Jun 20, 2012), and end on Jun 25, 2012. The additional cost for the extension is $1,220.00, plus $190.00 if you have chosen the Single Supplement for the tour. Would you like to register for this extension?

I would like to register for this extension.
TOUR EXTENSION (optional)

This tour has an optional extension, entitled Lake Titicaca: The Heart of Mama Cocha. It will begin on the last day of the tour (Sep 24, 2012), and end on Sep 28, 2012. The additional cost for the extension is $980.00, plus $275.00 if you have chosen the Single Supplement for the tour. Would you like to register for this extension?

I would like to register for this extension.
ACCOMMODATION OPTIONS

Price Description Price
The Desert Shaman: Mar 30 - Apr 14 USD $1,540.00
Teotihuacan & The Desert Shaman: Mar 27 - Apr 14 USD $2,040.00
The Circle of Twelve: Mar 30 - Apr 21 USD $2,172.00
Teotihuacan & The Circle of Twelve: Mar 27 - Apr 14 USD $2,680.00

Price Description Price
Double/Twin Room USD $2,295.00
Quad Room USD $1,995.00

Price Description Price Single Supplement*
Price with Hotel USD $1,150.00 USD $200.00
Price without Hotel USD $950.00 USD $0.00

I would like a:

Double Room  Single Room    I would like to find a roommate

*The single supplement is for those who would like to secure a private room throughout the tour, at the indicated additional price. If you are not traveling with anyone you know and would like to share a room, please indicate your preferences for a roommate above. We will be happy to work to find you a suitable roommate.


PAYMENT OPTIONS

Deposit (US $500 per person)
Payment in full (due if you are booking within 70 days of departure)

Personal Cheque sent via regular mail, made out to Sacred Earth Journeys and mailed to: Sacred Earth Journeys, 7348 Ridge Drive, Burnaby, B.C. V5A 1B5 Canada

Bank Draft sent via regular mail (draft from your bank, made out to Sacred Earth Journeys and mailed to Sacred Earth Journeys, 7348 Ridge Drive, Burnaby, B.C. V5A 1B5 Canada)

I would like to pay by Visa. (we accept Visa only and there is a 3% in-house admin fee for Visa payments)

a) Please contact me by telephone for Visa credit card details

b) I am advising my Visa credit card details:

Visa Number
Date of Expiry
Name on Credit Card

I authorize Sacred Earth Journeys to debit my Visa credit card in the amount of
USD $.00

Representing:
Deposit

Payment Full


Please enter the text in the image above:

I have read and accept the Terms and Conditions.

 
 
 

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