YELLOW BRICK ROADS
ORDER FORM FOR TRANSPORTATION FOR HUKILAU 2009
Cost per person round trip:
$16 paid in cash
$18 paid with credit card – Visa
or Mastercard
Friday June 12:
Deadline to sign up for transportation is 5 pm on Thursday June 11
Jeff Beachbum Berry Seminar
Depart Bahia Cabana at 12:30 pm
x __________
Jeff Chenault Seminar
Depart Bahia Cabana at 1:30 pm
x ___________
Saturday June 13:
Deadline to sign up for transportation is 5 pm on Friday June 12
Mai-Kai 1st Dinner Show
Depart Bahia Cabana at 3:30 pm
x __________
Depart Bahia Cabana at 4:30 pm
x __________
Mai-Kai 2nd Dinner Show
Depart Bahia Cabana at 6:30 pm
x __________
Depart Bahia Cabana at 7:30 pm
x __________
Contact Information:
Name:
_________________________________________Cell phone:_____________
I will pay cash:
collected at registration desk on Thurs 2 – 5 pm and Fri 2 – 5 pm: _______
I will pay with a credit card Visa
or Mastercard
Prepaid vouchers for
transportation will be included in your registration package:
Please fill out below information
and fax to: 954 523 1165, call 954 523 5583 with information or email to: info@yellowbrickroads.com
I,_________________________ (name as it appears on credit card) authorize Yellow Brick
Roads Inc., to charge credit card number
(Visa or MC): __________________________________ Expiration
date:________
in the amount of $____________________________
Billing
address: _________________________________
City/State/Zip__________________________________________
Authorized Signature: _________________________________________
P.O.
Box 4634, Fort Lauderdale, FL 33338
Telephone:
(954) 523-5583, Fax (954) 523-1165