TOUR REGISTRATION FORM

Tour Name(s): ________________________________________________________________

Dates: ________________________________________________________________________

Name: 1. _________________________________________
2. _________________________________________

Street Address: ________________________________________________________________

City: __________________________ State: ____ Zip: _________ Country: ______________

Phone Number: Home __________________________ Work _________________________

Fax ____________________________ Email _________________________

I am a: (Please check) _____ Non-Smoker _____ Smoker

Enclosed is my deposit of: $_____________ for the person(s) listed above ($300 per person for U.S.

workshops and $1,000 for African workshop) which comes to a total of $_______________

Please make check payable to: DRAMATIC LIGHT NATURE PHOTOGRAPHY
and mail to: Dramatic Light Nature Photography

2292 Shiprock Rd.

Grand Junction, CO 81503

USA

Occupancy Preferred: (Please check)

_____ Single Occupancy (without a roommate) Add the listed single supplement to my bill.

_____ I will share a room with ______________________________________(Name)

_____ Please provide a roommate if possible.

I have read and accept the Cancellation Policy stated in the Brochure. I would like to make reservations for

the person(s) listed above. I understand that reservations will be accepted in the order received.

Signature _______________________________________________ Date_________________