PRINT THIS FORM TO MAIL TO US
C  H  E  S  A  P  E  A  K  E       C  H  A  P  T  E  R
U  N  I  T  E  D     S  T  A  T  E  S     L  I  G  H  T  H  O  U  S  E     S  O  C  I  E  T  Y
Cost of trip $3200.00 (double) members; $3250.00 (double) non-members; $2200.00 (single) members and $2225.00 (single) non-members.
Final payment is due on or before June 29, 2009.

Cancellation policy: Minimum $25 per person administrative fee, see detailed article for other fees that may apply.

August 29 - September 6, 2009 - Nova Scotia Trip
Ahoy, Betty!... Sign Me Up !
Here is some information for you.....
  Chapter Member:
 
Yes No
.
.
 
Name:
.
Address:
.
Telephone:
(          )
Email:
.
 
Enclosed is my payment for: 
$
  Which is for: 
.
  People.
Number of Chapter members:
 
 Number of non-members:
.
  


I have read and I accept the Terms and Conditions.

Any special needs (handicap, dietary, etc): _________________________________________

Room request (if available): ___ 1 Bed  ___ 2 Beds  ___ Smoking  ___Non-smoking

Please send this completed registration form with deposit ($100 pp) made payable to Chesapeake Chapter, USLHS to:
Betty Smith
7 Goldfinch Road
Audubon Park, NJ 08106

If you have any questions, call Betty at 856-546-7810, or email her at bjks313@comcast.net.

NOTE: Failure to complete all information required will result in your deposit and reservation being returned. Please provide valid contact information (phone and/or email).

BACK to August 29 - September 6 Details BACK to the Trips Page
2003(c) Chesapeake Chapter, USLHS. All rights reserved.