Registration Form

[Print out this form, complete, and send to our address below with your deposit.]

Students of all levels are welcome.

A non refundable $200 per person is due upon registration. The balance which is non refundable, is due by

December 30^th.

Please make sure you have vacation insurance if there is any unforeseen possibility of cancellation.

*Please include this form with your deposit

Puerto Morelos, Mexico

Name__________________________

Address________________________

City/State/Country_____________________

ZIP__________ Phone _________________

E-mail______________________________

Amount Enclosed_____________________

Further Information Contact:

Amanda McMaine

154 Redwood Dr

Richmond KY, 40475

Phone: (859) 624-0413

Amanda@eros.chapel1.com

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