EmailMe Form - High Vibe Women's Retreat

Full Name *

First Last

Date of Birth *

MM / DD / YYYY

Email *

Phone *

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Dietary Restrictions

Shirt Size

Pant Size

Shoe Size

Travel Insurance

We strongly recommend that you protect your investment with travel insurance. Cancellation and interruption insurance covers in case of cancellation due to an insurable reason.

Would you like a quote for travel insurance? *

Please send me a quote

I am fully covered by another insurance policy

I am declining travel insurance

Notes or Special Requests:

Terms & Conditions

Any payments are non-refundable after their due date. It is extremely important that all clients purchase travel insurance. This contract permits price increases except if the customer has paid in full. If the total price of the travel services are increased and the cumulative increase, except any increase resulting from an increase in retail sales tax or federal goods and services tax, is more than 7%, the customer has the right to cancel and obtain a full refund.
Dream Destination Travel, Rhonda Arnott and Trevello (TPI) cannot be held responsible for any errors, omissions, or mistakes on this form. Your reservation is subject to the rules and conditions of the retreat operator.
Rates do not include HST or the 4% credit card processing fee.

*

I have read, understand and agree to the Terms & Conditions above.

Payment Details

Name as on Credit Card. *

First Middle Last

Credit Card *

I authorize Dream Destination Travel (Trevello Inc) to charge the credit card indicated in this authorization form according to the terms outlined in the tour details. I understand that the card may be charged by third party suppliers in order to avoid unnecessary credit card processing fees. This payment authorization is for the trip described previously, and my credit card may be kept on file for future payments. I will always be notified prior to any future charges. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company, so long as the transaction corresponds to the terms indicated in this form. *

I have read, understand and agree to the payment terms above.