- Discover Samuel

© 2016 EarthLight, Inc.
TERMS AND CONDITIONS FOR SAMUEL’S 2016 GROUP TRIP TO GUATEMALA
READ THIS CAREFULLY
SPACE IS VERY LIMITED, HALF THE ROOMS WILL BE TRIPLE OCCUPANCY.
YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS
Please make sure you read this entire document; it has critically important information in it. By registering for this
trip, you acknowledge that you have read, understood, and fully accepted all the terms and conditions contained in
this document for the 2016 group trip with Samuel.
ELIGIBILITY: THIS IS NOT A VACATION!
These trips are designed for those who are currently active in Samuel’s work, are familiar with his teachings, AND
who plan to fully participate in the group’s work.
Please do not sign up for this trip unless you fulfill these guidelines. EarthLight reserves the right to limit registration
to those who meet these criteria.
TRIP BEGINNING & ENDING INFORMATION:
1. The first hotel night is Friday, October 21.
2. The first group meal will be dinner on October 21, 2016.
3. The first group meeting is scheduled for Saturday morning on October 22.
4. The last group meeting is scheduled for Saturday, October 29.
5. The last hotel night is Saturday, October 29.
6. The last included meal is breakfast on October 30.
INCLUDED IN THE COST OF YOUR TRIP
• Regular meetings with Samuel
• Transportation and entry fees for the specific group excursions listed in the brochure
• 9 vegan, onion/garlic-free, gluten-free* dinners (starting October 21)
• 9 vegan, onion/garlic-free, gluten-free* breakfasts (starting October 22)
• 8 vegan onion/garlic-free, gluten-free * lunches (starting October 22)
• Tips for staff, servers, housekeepers, and porterage for all included services at Villa Sumaya
• Tips for drivers (boat, van/bus, tuk tuk), and guides for all included site visits.
• Payment of 22% tax on all included services
• Unlimited tea/coffee service
• Unlimited filtered drinking water
* Villa Sumaya does not operate a gluten-free kitchen and will do its best to serve only food that does not contain
gluten. However, foods such as oats that are used may not be labeled as gluten-free.
NOT INCLUDED IN THE COST OF YOUR TRIP
• International airfare to/from Guatemala
• Transportation to Villa Sumaya from La Aurora International Airport which serves Guatemala City; or from the
hotel to La Aurora International Airport. See “Airport Transfer” section below for information concerning
obtaining your own transfers. Please note that Villa Sumaya is not accessible by road. Therefore the last section
of your transfer to the hotel (and the first section of your transfer back to the airport) will be by a 15-30 minute
boat ride.
• Meals, food, and beverages over and above those listed in the section above.
• Wifi (however once you are there, wifi can be added for $3 per day or $20 for the entire trip.)
• Tips for any services not listed as included above, or any additional tips you may wish to give for any special
services you’ve received.
• Environmental levy, airport security and departure tax. (According to the US State Department: There is an exit
tax (currently 30 USD) for departing Guatemala by air. The tax is generally included in an airline ticket price,
but may be charged separately. There is an additional airport security fee (currently 20 Quetzales, or approximately
2.60 USD) that is also included in the ticket price.)
(3)
•
•
Any other items not specifically listed as “included” in these Terms & Conditions, or in EarthLight’s promotional
material for this trip
Travel Insurance—we highly recommend that you purchase trip insurance for this trip.
AIRPORT TRANSFERS
You are welcome to arrange your transfer from La Aurora International Airport in Guatemala City to the hotel, and
from the hotel back to the airport with any provider you wish. However, we have made arrangements for transfers
with the tour company we used for our scouting trip, and which has arranged and is providing the ground portion of
this group trip. Having experienced their vans and drivers, we would recommend using this company. Additionally,
they are including in their transfer cost not only the transfer from and to the airport to Lake Atitlan, but also the boat
transfer to and from the hotel. Tours Atítlan transfers will cost $140 for one to four people and $30 for each additional
person. To use this recommended company please email the contact info below letting them you are with the October
2016 EarthLight Group, your flight number, and the day your flight will be arriving.
Tours Atitlan e-mail: [email protected]
PASSPORT AND VISA INFORMATION
Please see the United States Department of State website:
https://travel.state.gov/content/passports/en/country/guatemala.html
This site contains extensive information helpful for travelers, including:
PASSPORT VALIDITY: Passport must be valid for length of stay
BLANK PASSPORT PAGES: One page required for entry stamp
TRIP INSURANCE
Trip insurance is not included in the cost of this trip. Therefore, we highly recommend that you purchase insurance
covering this trip, including insurance for cancellation, trip interruption, lost luggage, transportation home in the event
of illness or injury, as well as health coverage. If you need to cancel your participation in this trip, EarthLight will
not be able to refund any amount of your payments other than as specifically set out herein. If you require medical
care while on this trip and the related service providers require payment, you will need to arrange for payment. Please
do not count on EarthLight or the other trip participants to take care of this for you! NOTE: Travel insurance policies
are available that cover pre-existing conditions. HOWEVER, most of these policies require you to purchase the
insurance within a few days of making your first payment to EarthLight (as few as 7 days after payment). So please
be sure to look into travel insurance right away.
REGISTRATION & RELATED INFORMATION
Space and types of rooms on this trip are VERY LIMITED.
Because of the very limited number of spaces available, we expect this trip to sell out very, very quickly. If you mail,
overnight, or even hand deliver your registration, it is possible that there may be no spaces available when your
registration is received. People will be registered on a first-come, first-served basis and will be considered registered
for the trip as of the date and time their completed registration and payment is actually received in hand by and
accepted by EarthLight.
HOW TO REGISTER
EarthLight recommends that everyone (even Lexington residents) register by emailing or texting a filled registration
with their deposit credit card information to Frank: email: [email protected], or text: 859-338-0746. You can
make an image of your filled out registration form by scanning it or taking a picture of it and attaching it to an email
or text. By texting or emailing your registration and payment, “received by EL” will be the date and time Frank’s
email account or phone receives them.
You can hand-deliver your registration and payment to 147 Kentucky Ave., Lexington, KY 40502. But if we’re not
home when you arrive, your registration won’t be “received by EL” until we come home and actually receive it.
Of course, you can still register by regular mail or overnight mail using our street address (147 Kentucky Ave.,
Lexington, KY 40502-1754) rather than our P.O. Box address (which we only check occasionally). However, based
on the limited availability of spaces for this trip, we believe all the spaces for this trip will be filled very quickly
(4)
(possibly before the end of the day on the day the trip is announced).
ROOMMATES
Accommodations during this trip are available on a double and triple-occupancy basis only. (Single rooms are NOT
available. Please don't ask.) If there are an odd number of male and female participants without roommates, it may
be required that one room will be shared by individuals of different genders.
If, however, an odd number of participants results in a person having a room to her/himself, there will be no extra
charge for that person.
PLEASE NOTE: Listing one or more roommates on your registration form will NOT hold their spot as your roommate.
If you want to insure that you and your desired roommate(s) will share a room, we recommend that you include both
(or all three) person’s credit card information on the registration form so that the roommates’ registrations will be
received at the same time. Or, of course, you can make arrangements with your roommate(s) to pay their deposit(s)
with yours and be paid back from them.
If you sign up without a roommate, we will pair or triple you with others as soon as possible and let you know if a
room has been assigned to you. For the first 24 hours after registration opens, registrations that include roommate(s)
that fill all bed spaces in a preferred room will be given priority over those that register by themselves or who register
with a roommate but don’t fill the room’s bed spaces. Thereafter, EarthLight will begin doubling/tripling roommates.
TYPES OF ROOMS
Each room at Villa Sumaya is different and they consist of a variety of bed configurations. Check the listing below
to see the room variations available. The variations of per person costs for this trip are based on the room type,
configuration, and location. The room descriptions on the Villa Sumaya website describe the rooms accurately, except
that rooms 4, 5, and 6 can have either one queen bed or two twin beds.
http://villasumaya.com/our-center/guatemala-spa-resort/
Rooms with 3 beds will be will have three occupants.
Rooms with either a queen or king bed and a twin bed/futon will have three occupants unless limited registrations
permits otherwise. Please be aware of and consider this when you register. (EarthLight would like for as many people
as possible have the opportunity to participate in this special time with Samuel.)
ROOM REQUESTS
When you register you’ll be asked to list your room preferences by priority. We request that you list as many priorities
as possible (you may want to list all 20 rooms by priority). If none of your room priorities are available, you will not
be registered for the trip, and will be notified of that.
PAYMENT OPTIONS*
You may register and:
1. Pay in full with your registration.
2. Email or text your registration, paying the deposit by credit card and then, to avoid the $50 payment plan
administration fee, you can pay the balance within seven days by check.
We realize that some will want to register by email or text and pay their deposit quickly by credit card, but may
not want to use EarthLight’s payment plan. Therefore, if you register and pay your deposit by credit card, and
then you pay the remaining balance of your full registration cost so that we receive it within 7 days of your initial
registration, you will not owe any payment plan fee or any additional fees. The fee for paying the deposit by
credit card is $27.22, just a little more than over-night delivery.
3. Pay using EarthLight’s payment plan:
After your initial deposit, payments will be due on or before July 1, August 1, September 1, and October 1, 2016.
(We’ve included a nonrefundable $50.00 administration fee; $52 if paid by credit/debit card.)
Please see payment details at the end of this brochure before the registration form.
* A discount of 3.67% is provided those who pay by cash, check or money order, with the amount due being rounded
to the nearest dollar.
(5)
Trip cost per room:
Room #
Bed configuration
per person cost (double occupancy)
per person cost (triple occupancy)
2 .......................(2 twins) ..........................................................................................................$3,176.00*
3 .......................(2 twins) ..........................................................................................................$3,176.00*
4................(queen or 2 twins)...................................................................................................$3,239.00*
5................(queen or 2 twins)...................................................................................................$3,239.00*
6................(queen or 2 twins)...................................................................................................$3,239.00*
7 ................(1 queen w/futon)..............................($3,428.00*)** ............................................$3,158.00*
8..............(1 queen & 1 twin in ...........................($3,131.00*)** ............................................$2,996.00*
separate sitting room)
9.......................(1 queen)..........................................................................................................$3,104.00*
10.......................(1 queen)..........................................................................................................$3,212.00*
11 ...............(1 king and 1 twin).............................($3,509.00*)** ............................................$3,257.00*
12 ..............(1 queen and 1 twin) ...........................($3,509.00*)** ............................................$3,257.00*
13 ........................(3 twin)......................................($3,509.00*)** ............................................$3,357.00*
14 ........................(3 twin)......................................($3,509.00*)** ............................................$3,357.00*
15 ...............(1 king and 1 twin).............................($3,509.00*)** ............................................$3,257.00*
16 ........................(3 twin)......................................($3,509.00*)** ............................................$3,357.00*
18 ................(1 queen Jr Suite) ...................................................................................................$3,509.00*
20.......................(1 queen)..........................................................................................................$3,212.00*
21 ...............(2 twin & 1 queen).............................($3,869.00*)** ............................................$3,581.00*
* for payments made by credit card multiply this amount by 1.0367 to get the amount that is due.
** These are triple occupancy rooms. However, if the trip does not sell out, the double occupancy rate will apply
for these rooms.
For room descriptions see: http://villasumaya.com/our-center/guatemala-spa-resort/
[For your planning, please know that Frank, Lea, and Stuart are rooming in rooms 17 and 19.]
PAYMENT PLAN SCHEDULE:
If you pay using EarthLight's payment plan, $50* of your deposit is your payment
plan administration fee.
The remaining balance due after your deposit equals your total cost (listed above)
less your $700* deposit. The remaining balance is due in four equal monthly
installments on the following dates:
• first payment due on or before July 1, 2016
• second payment due or before August 1, 2016
• third payment due or before September 1, 2016
• fourth payment due or before October 1, 2016
Payment amounts due for each of 4 payments under EarthLight's Payment plan:
Double Occupancy
Triple occupancy
Room
Balance after deposit
Payments
Balance after deposit
Payments
2......................$2,476.00*................619.00*
3......................$2,476.00*................619.00*
4......................$2,539.00*................634.75*
5......................$2,539.00*................634.75*
6......................$2,539.00*................634.75*
7 ..................($2,728.00*)** ............682.00*.....................................................$2,458.00* .......614.50*
8...................$2,431.00*)** .............607.75*.....................................................$2,296.00* .......574.00*
9......................$2,404.00*.................601.00
11 ..................($2,809.00*)** ............702.25*.....................................................$2,557.00* .......639.25*
(6)
Payments due for each payment under EarthLight's Payment plan:
Double Occupancy
Triple occupancy
Room
Balance after deposit
Payments
Balance after deposit
Payments
12 ..................($2,809.00*)** ............702.25*............................................$2,557.00* ................639.25*
13 ..................($2,809.00*)** ............702.25*............................................$2,657.00* ................664.25*
14 ..................($2,809.00*)** ............702.25*............................................$2,657.00* ................664.25*
15 ..................($2,809.00*)** ............702.25*............................................$2,557.00* ................639.25*
16 ..................($2,809.00*)** ............702.25*............................................$2,657.00* ................664.25*
18 .....................$2,809.00*................702.25*
20 .....................$2,512.00*................628.00*
21 ..................($3,169.00*)** ............793.25*............................................$2,881.00* ................720.25*
* for payments made by credit card multiply the amounts by 1.0367 to determine the amount due.
**These are triple occupancy rooms. However, if the trip does not sell out, the double occupancy rate will apply
for these rooms.
WAITING LIST
Due to the very limited number of spaces and popularity of Samuel’s group trips this trip will most likely sell out
very quickly. If it does you can place your name on the waiting list by sending us your completed registration form
with your initial deposit. If a space does not become available, your payment will be refunded in full.
If a space does become available, you will be notified, after which you must let us know within 24 hours whether or
not you plan to take the available space. If we do NOT hear from you by the expiration of those 24 hours, your
payments will be refunded and your space will be made available to the next person on the waiting list. If you let us
know within that 24-hour period that you do want to take the space you’ll need to immediately pay either the remaining
price in full (you will not owe a payment plan fee if this happens); or you need to pay all installment payments that
have became due prior to your joining the trip, as well as pay future installments as they become due (in that instance
your payment plan fee will be added to the cost of your trip). We will allow 48 hours from notifying you of an opening
for us to receive these required payments. If we haven’t received your catch-up payment within that time period your
name will be removed from the waiting list, your deposit will be refunded, and the space will be made available to
the next person on the waiting list.
If a space becomes available after October 9, 2016, these time limits may be accelerated.
LATE REGISTRATION
EarthLight is leaving for Guatemala on October 19, 2016. Therefore, even if space on the trip is or becomes available,
we will not be able to add people to this trip unless payment in full (and all registration information) is received before
Noon Eastern Time, October 17, 2016.
PAYMENT INFORMATION
3.67% DISCOUNT FOR PAYING BY CASH OR ITS EQUIVALENT
EarthLight will accept payment(s) for this trip by cash, check, and money order, as well as Visa, MasterCard, Discover
and American Express credit/debit cards. All payments made by cash, check, or money order will receive a discount
of 3.67% as indicated in these Terms & Conditions.
POSTDATED CHECKS
Please don’t send postdated checks. Any postdated check we receive will, at our discretion, either be deposited (our
bank accepts postdated checks), or returned to you, in which case you may owe late fees.
RETURNED CHECKS
Any checks that we receive that are dishonored by your bank will result in a $30 fee being due within 14 days of the
date we are notified of the check being dishonored. This additional $30 will be considered a part of your cost for this
trip. Nonpayment or late payment of such fee will be considered a nonpayment or late payment of an installment
under that installment payment plan as outlined.
(7)
GRACE PERIOD AND LATE PAYMENT FEE
If you are paying by way of the payment schedule you are allowed a grace period of five (5) days after the date
payments are due. A fee of $50.00 will be charged for each payment that is actually received by us after the grace
period expires (regardless of the date of the postmark). Any fee owed for late payment shall be due within 14 days
of the payment's receipt by Earthlight, or 30 days prior to the start of the trip, whichever is earlier. Such fee will be
considered a part of the cost of this trip, and nonpayment or late payment will be considered a late payment or
nonpayment of an installment under that installment payment plan as we’ve outlined in this document.
AUTOMATIC CANCELLATION FOR LATE PAYMENT OR FOR NONPAYMENT
For those using the payment schedule, if a payment has not been received within 5 days after the end of the grace
period (10 days after the date the payment was due), and no other arrangements have been made with us, your
registration for this trip will automatically be canceled and your space vacated. If your registration is automatically
canceled, all money you have paid will be refunded, less any cancellation fee as described in the “Cancelation
Information” section of these Terms and Conditions. We would hate for this to happen, so please contact us if you
are having problems making payments!
CANCELLATION INFORMATION
CANCELLATION FEES
Please be sure you are committed and able to pay for this trip before signing up. Any cancellation is effective upon
the date we receive your notification. If you phone us to cancel and get voice mail, please leave a message stating
that you are canceling from the trip, the date, and your phone number. We will get in touch with you as soon as we
can. Cancellation fees, based on your method of payment and on the dates given to us by our suppliers, are as listed
below. If you leave a voice message and do not CLEARLY state that you are canceling from the trip, the date when
your cancellation is effective will be the date that your cancellation is clearly received by EarthLight:
Cancellation fee upon registration:
Cash, Check, Money Order $750.00*
Credit/debit card
$778.00
Cancellation fee beginning
July 15 a total of $1,300.00**
August 15 a total of $1,900**
September 15 a total of $2,500**
October 15 a total of your entire registration cost**
* A discount of 3.67% is provided those who pay by cash, check or money order, with the amount due being rounded
to the nearest dollar.
** Added to cancellation fees are all administration fees, late fees, and returned check fees that are due or have been
paid.
If before October 19, 2016 (the date EarthLight will leave the country), you must cancel, please email or text us at:
email: [email protected] or text: 859-338-0746 even if you have also called.
NO TRANSFERS OF REGISTRATION
If you cancel your registration or drop out of the trip your registration will be null and void, and, therefore, may not
be, and cannot be transferred to anyone else. Even if you have to cancel and someone else takes your space, we’ll
not be able to refund any of your payments. Please protect yourself with trip cancellation insurance.
(8)
REINSTATEMENT
In the event you cancel your registration (or are automatically canceled for late payment or nonpayment), you can
be reinstated, if space is available. In order to be reinstated, you must pay:
1. any fees that were owed at the time of your cancellation,
2. a $50 reinstatement fee ($52 if paid by credit/debit card),
3. the total cost of the trip, less the actual trip costs withheld by EarthLight when you canceled. You will not receive
credit for any administration fees, late fees, or returned check fees you paid prior to cancelation.
NO SHOWS
If you are a no-show, or leave during the group trip, EarthLight will be unable to provide you any refund.
EMERGENCY CARE AND EMERGENCY CONTACT PERSON
EarthLight requires all registrants provide emergency contact information with their registration. Frank, Lea, Stuart,
and the service providers EarthLight has contracted with are not trained in first aid or to provide medical care. In the
event of an accident or illness we will do our best to see that first aid is provided. However, Frank, Lea, Stuart, and
the service providers contracted with by Earthlight are not responsible for providing (or for the costs of providing)
first aid, medical transportation, medical care or communications with caregivers. Frank, Lea, and Stuart will, however,
attempt to contact the person listed as your emergency contact in order to inform them about what has happened,
where you are being treated, and how to contact your health care provider in Guatemala, if that information is available.
Please make sure that your emergency contact person has a copy of all appropriate information including: any travel
insurance you purchase, your personal health insurance papers, your itinerary, and any other necessary paperwork.
EARLY ARRIVALS AND STAYING OVER
We've noticed during our recent group trips with Samuel that some people like to arrive before the official start of
the trip, and some like to stay after the trip ends. You can arrange pre or post group trip accommodations by emailing
Michelle at: [email protected]
Once you know which room you have been assigned to, you can ask if that room will be available for the time you
are staying either before or after the group trip.
PLEASE NOTE: Your arrangements and payment for extra nights must be made directly with Villa Sumaya. Frank,
Lea, Stuart, or EarthLight shall not be responsible or liable for any aspect of those arrangements, or for your satisfaction
with any aspect of those arrangements.
WEATHER
Lake Atitlan is in the highlands of Guatemala, just over 5,000 feet above sea level. That means that even though this
trip is to a tropical country, you should expect spring-like weather. The area stays cool enough that hotels don’t have
air conditioning (the highs will reach the low 80s, but the lows will dip into the 40s). We generally carried a jacket
with us everywhere we went, though we ended up carrying it quite a bit. It is very chilly on the water and all our
excursions will take us by boat for at least part of the trip.
The rainy season is ending during late October with November starting the dry season. During this time of year, it
is not unusual for it to rain in the late afternoon and/or during the nights. For October, the weather in Panajachel, the
largest city in the Lake Atitlan region is listed at
www.wunderground.com as being:
Temperature:
MAX
AVG
MIM
High
77° F
68° F
69 to 73° F
Low
63°F
54°F
48 to 53°F
Precipitation:
Rain
1.16 in
0.00 in
0.00 in
You can get more accurate weather information from research than you can get from us.
(9)
FRANK, LEA, STUART & EARTHLIGHT, INC.
Any references to “Frank, Lea, and Stuart” are to Frank Schultz, Lea Schultz, and Stuart Waldner, the owners and
sole employees of EarthLight, Inc., a Kentucky corporation.
IF EARTHLIGHT MUST CANCEL
If EarthLight has to cancel the trip, it will refund all payments you have made less your pro-rata portion of any
nonrefundable money EarthLight has paid, or becomes obligated to pay, as of the date of its cancellation.
DISCLAIMERS
Due to the possibility of schedule changes and other unforeseen occurrences, there can be unexpected schedule
changesóthere always are. EarthLight, Inc., its owners, employees, officers, directors, helpers, and volunteers shall
not be liable for any loss, damage, or added expense resulting from personal injury, sickness, property damage,
accident, delay, unmet expectations, inconvenience, change in schedule or accommodations, or other irregularity that
may occur due to: a) wrongful, negligent, willful, or arbitrary acts or omissions on the part of any organization(s) or
individual(s), including those supplying services to the group during this trip; b) defects or failures of any conveyance,
equipment, or instrumentality or accommodation; c) acts, omissions, failures to act, or any other occurrence beyond
its/their control and, d) acts of God/Goddess/All That Is, fire, acts of government or other authorities, wars, civil
disturbances, riots, strikes, thefts, pilferage, epidemics, quarantines, acts of terrorism, or dangers incident to the air,
land. and sea travel. Arrangements for this trip have been made through generally acceptable suppliers, and each
participant agrees to hold Frank, Lea, Stuart, and EarthLight, Inc. harmless for any failure of this trip, or any part of
it, to meet their expectations. The liability of Frank, Lea, Stuart, and EarthLight, Inc., if any, shall be limited to each
individual's cost of this trip or the amount retained by EarthLight, Inc. from each individual's payment for this trip,
whichever shall be less. EarthLight, Inc., under no event, shall be liable for consequential or punitive damages. Whew!!
(10)
EarthLight’s 2016 Lake Atítlan Group Trip Registration Form
By registering I am agreeing to the Terms and Conditions of the 2016 Lake Atítlan group trip with Samuel.
You must provide payment and ALL of the information requested in this Registration Form.
CONTACT INFORMATION
ROOMMATES
Name ___________________________________________
The following has/have agreed to be my roommate(s):
Home Address _____________________________________
Name: ____________________________________________
City/State ____________________/____ Zip _________
Email: ____________________________________________
Phone: (h) _________________ Cell: ________________
Name: ____________________________________________
e-mail: ___________________________________________
Email: ____________________________________________
All future communications regarding this trip will be by email.
ROOM PREFERENCE
GROUP TRIP REGISTRATON PAYMENT*
Please mark the priority of the rooms you’d be willing to accept.
Rooms will be assigned first-come-first served. Priority will
be given to those who sign up with paid roommates that fill
the room for the first 24 hours after registration opens;
thereafter, EarthLight will begin doubling/tripling
roommates.
I am paying in full for room number _____ (I understand that
if the cost of the room I am assigned to is less than I’ve paid,
I’ll receive a refund of the difference within 7 days; if it is
more than what I’ve paid I’ll pay the balance due within 7
days.)
NOTE: Your registration will be cancelled if all your room
preferences are unavailable, and your/your roommate’s credit
card(s) will not charged or your check(s) will be returned.
Choice Room
Beds
per personper person
priority
(double)
(triple)
_____
2
(2 twins)
$3,176*
_____
3
(2 twins)
$3,176*
_____
4
(2 twins)
$3,239*
_____
5
(2 twins)
$3,239*
_____
6
(2 twins)
$3,239*
_____
7
(1 queen w/futon) ($3,428*)** $3,158*
_____
8 (1 queen & 1 twin in ($3,131*)** $2,996*
separate sitting room)
_____
9
(1 queen)
$3,104*
_____
10
(1 queen)
$3,212*
_____
11 (1 king and 1 twin) ($3,509*)** $3,257*
_____
12 (1 queen and 1 twin) ($3,509*)** $3,257*
_____
13
(3 twin)
($3,509*)** $3,357*
_____
14
(3 twin)
($3,509*)** $3,357*
_____
15 (1 king and 1 twin) ($3,509*)** $3,257*
_____
16
(3 twin)
($3,509*)** $3,357*
_____
18
(1 queen Jr Suite)
$3,509*
_____
20
(1 queen)
$3,212*
_____
21 (2 twin & 1 queen) ($3,869*)** $3,581*
1) ____ I’m including payment in full for myself for my first
Choose one of the following options.
priority room marked above.
2) ____ I’m including my deposit of $750* for my first priority
room marked above, and will pay the balance either within 7
days or by using the payment plan offered by EarthLight.
I am paying ____by check ______ by credit card
Card Type: ___VISA ___MC ___ Discover ___AMEX
Card #: _________________________________
exp. ____/____
CVC ____
Signature: _________________________________________
Name on card: _______________________________________
Credit card billing Zip Code ___________
Registration Form continued on next page.
* for payments made by credit card multiply this amount by 1.0367 to get the amount that is due.
** These are triple occupancy rooms. However, if the trip does not sell out, the double occupancy rate will apply
for these rooms.
(11)
EarthLight’s 2016 Lake Atítlan Group Trip Registration Form
(continued)
FOR MY ROOMMATE(S)
Roommate #1*
Roommate #2*
I’m authorized by my roommate(s) to:
I’m authorized by my roommate(s) to:
____ include their payment with mine for our first priority
____ include their payment with mine for our first priority
room choice,
room choice,
____ provide their credit card information (below),
____ provide their credit card information (below),
____ deliver their check.
____ deliver their check.
I am providing payment for my roommate, _____________,
I am providing payment for my roommate, _____________,
in the amount of_________by ___ check or by ___ credit card
in the amount of_________by ___ check or by ___ credit card
(if this is not my credit card, I am authorized by its owner to
(if this is not my credit card, I am authorized by its owner to
give you this information)
give you this information)
Card Type: ___VISA ___MC ___ Discover ___AMEX
Card Type: ___VISA ___MC ___ Discover ___AMEX
Card #: ____________________________ exp. ____/____
Card #: ____________________________ exp. ____/____
CVC ____
CVC ____
Signature:____________________________________
Signature:____________________________________
Name on card: ___________________________________
Name on card: ___________________________________
Credit card billing Zip Code ___________
Credit card billing Zip Code ___________
* My roommate(s) understand that if the cost of the room we are assigned to is less than they’ve paid, they’ll receive
a refund of the difference within 7 days; if it is more than what they’ve paid they’ll pay the balance due within 7 days.
EMERGENCY CONTACT
MEDICAL CONDITIONS
Please list any allergies and medical conditions, along with
any medications you are taking for them. (attach extra page if
needed)
The name of my emergency contact person is:
_______________________________________________
Their relationship to me is: ________________________
_____________________________________________
Their phone: (______) ___________________________
_____________________________________________
cell/mobile: (______) ____________________________
_____________________________________________
e-mail: _________________________________________
_____________________________________________
TO REGISTER
_____________________________________________
Please complete this registration form in its entirety and mail,
fax or deliver it with your payment to:
_____________________________________________
_____________________________________________
EarthLight, Inc.
_____________________________________________
147 Kentucky Ave.
_____________________________________________
Lexington, KY 40502
_____________________________________________
© 2016, EarthLight, Inc.
(12)