Black Icelandic Adventure
Registration/Deposit
I confirm the dates of this trip are February 28-March 3, 2020
*
Yes
No
Name
*
First Name
Last Name
Referral Name
Age
*
Email
*
example@example.com
Instagram/Facebook User Name
*
Phone Number
*
-
Area Code
Phone Number
Best Available time for contact
Gender
Female
Male
T-shirt size
S
M
L
XL
XXL
XXXL
Payment Amount will be determined based on deposit date. Final payment date February 1, 2020
*
Pay in Full total investment ($950)
Monthly payments
biweekly payments
I Acknowledge that at the hotel/villa (Hilton) accommodations are double occupancy. Often two double/twin beds. Type Yes or No
*
I also acknowledge that weather conditions can vary on the island therefore making some excursions impossible or delayed.
*
Yes
No
I also acknowledge understand all payments to BlackTravelGram are non-refundable. Payment may be transferred to another experience for an additional fee. I further acknowledge that to protect my travel investment, I must purchase optional travel protection at my own expense.. *
*
Yes
No
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