Wine Education Abroad - Piemonte 2023 - Registration

Details for Single Traveler
First Name*
First Name
Last Name*
Last Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number*
Please enter a valid phone number.
Your Date of Birth (Traveler #1)*

MonthDayYear
Date
Do you have any physical or mental illness or disability? Please note if you have trouble walking, standing for long periods, climbing stairs or any other condition that could affect your ability to fully participate in the Trip.*

NOYES
Please list any limitations we should be aware of*
Please give as much detail as possible.
Do you have any food allergies or intolerances?(Required)*

NOYES
Please list your food allergies or intolerances*
Please give as much detail as possible.

By signing your name below, you acknowledge that you have read and agree to be bound by the TERMS & CONDITIONS FOR WINE STUDY TRIPS set forth by Turicum, LLC.

Furthermore, you acknowledge that completing this form does not guarantee a place on the trip. Preference will be given to students who have completed at least WSET Level 2 with Napa Valley Wine Academy, at the Academy’s discretion. Do not make any travel arrangements until you have received and paid your initial non-refundable deposit invoice, which will serve as confirmation of your trip participation.
SIGN HERE*

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Details for Single Traveler