Registration for Trips | Travel with Wild Blue Yonder

Which trip are you registering for?*

How did you hear about this trip?*

Name*

First Last

Address*

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

Home Phone

Work Phone

Cell Phone

Email

Enter Email Confirm Email

Do you plan to stay on for the optional trip extension?*

Yes
No

(Note that you can change your mind on this question later, if desired.)

Is it okay for us to share your email address with other trip participants (but with no one else, of course)?

Yes, that's fine
No, I'd prefer you didn't

Emergency Contact

Emergency Contact Name*

First Last

Relationship to you*

Emergency Contact Home Phone

Emergency Contact Work Phone

Emergency Contact Cell Phone

Emergency Contact Email*

Enter Email Confirm Email

Traveling Companion

Will you be traveling with someone else?*

Yes
No

Traveling Companion Name

First Last

Will you share a room or each have your own room?

Share
Each have own room

Payment

Would you prefer to pay your deposit by check or with PayPal?*

PayPal
Check

Paying with PayPal

Sheila will email you an invoice that can be paid with PayPal. PayPal accepts all major credit cards. PayPal invoices will include a 3% surcharge to cover processing fees.

Paying by Check

Make checks out to Wild Blue Yonder.

Mail checks to:
    Sheila Campbell
    Wild Blue Yonder
    1001 Spring Street, Suite 623
    Silver Spring, MD 20910

Agreement to Terms and Conditions

*

I have read the Terms & Conditions associated with this trip prior to registering.

*

I understand the refund terms and conditions should I cancel my trip for any reason. I have been advised that I should purchase trip insurance to cover the costs of cancellation.

I have read the section on Health and Medical Issues carefully and certify that I am able to meet the physical specifications for this trip, which require walking long blocks, sometimes uphill or on uneven surfaces, up to a mile at a time, and climbing several flights of stairs without assistance.*

Yes
No