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					                                             Registration Form – Hotel
                                                    PLEASE PRINT CLEARLY OR TYPE


          SUBMIT REGISTRATION FORM TO SUNDANCER CRUISES BY MAIL, PDF OR FAX
First Name                                                          Last Name

Address

City                                                                State                 Zip Code                       Country

Home Phone                                     Work Phone                                 Cell Phone

Email Address                                                                             Website

Date of Birth                                                                                                    Male              Female

ROOM MATE INFORMATION
Room Mate’s First Name                                                   Room Mate’s Last Name
                                                                         Relationship
Date of Birth
Email Address:                                                              Male          Female
HOTEL INFORMATION
   Group Hotel Fira Palace        Other – Name of Hotel :
Type of room if other than standard:
  King           2 Beds                                                          Smoking                         Non-Smoking
Occupancy           Single Occupancy            Double Occupancy                 Triple Occupancy                Quad Occupancy
Select Dates
  9/26/2011                 9/27/2011                 9/28/2011                           9/29/2011                       9/30/2011
Other Dates in September Pre Cruise
  10/8/2011        10/9/2011          Other Dates in October Post Cruise


PAYMENT BY CREDIT CARD (One credit per room)
Please Check Type of Credit Card Below
   Discover                  MasterCard                   American Express                  Visa                         Other
Your name as it appears on the credit card


Credit Card Number

CVC=Card Verification Code (Last 3 digits on the       Expiration Date                                Billing Zip Code
signature bar on the back of card) *

If billing address differs from above address please list entire address here:

Other payment comments or instructions



Signature: __________________________________________________ Date: _____________________________________


                              Cathy & Brent Paxton of Sundancer Cruises, Inc.
                    Phone 303-250-7344 in Colorado or Toll Free at 1-866-409-SAIL (7245)
                                 Fax 303-284-0983 (Dedicated line on 24/7)
                  E-Mail info@SundancerCruises.net ● Website www.SundancerCruises.net

				
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posted:10/19/2011
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