Nature Macro Photography Workshop in Costa Rica

Nature Macro Photography Workshop in Costa Rica
Registration Form

A non-refundable deposit of US$ 350 is required at the time of registration to secure a place in the Workshop
Workshop date

Other
Rooming preference
Name

First NameLast Name
Email
example@example.com
Phone Number

Country CodeArea CodePhone Number
Alternate Number

Country CodeArea CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Passport number
Expiration date

MonthDayYear
Country of issue
Date of birth

MonthDayYear
Date
Arrival date

MonthDayYear
Date
Departure date

MonthDayYear
Date
Flight info
Please provide your complete flight information: carrier, flight number, dates and times (including any connecting flights) for your arrival to and departure from San José International Airport.
Emergency contact #1

Please provide the emergency contact information for someone not traveling with you on this tour.
Emergency Contact #1

First NameLast Name
Relationship
Emergency Contact #1 Email
example@example.com
Emergency Contact #1 Phone Number

Country CodeArea CodePhone Number
Emergency Contact #1 Alternate Number

Country CodeArea CodePhone Number
Emergency Contact #1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency contact #2

Please provide the emergency contact information for someone not traveling with you on this tour.
Emergency contact #2

First NameLast Name
Relationship
Emergency contact #2 Email
example@example.com
Emergency contact #2 Phone Number

Country CodeArea CodePhone Number
Emergency contact #2 Alternate Number

Country CodeArea CodePhone Number
Emergency contact #2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Dietary restrictions
Describe any diet preferences or restrictions that you might have. This field is required to submit your form, if you have no dietary restrictions or preference, please type "none" in the form field.
Health issues
List any health issue you feel to be relevant to your travel, including any medication allergies. This field is required to submit your form, if you have no health issues, please type "none" in the form field.
Comments / Questions
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Nature Macro Photography Workshop in Costa Rica

Registration Form