Registration Form Packing List Important Phone Numbers Waiver of Responsibility

Home > EcoClassroom > Information for Travelers > Registration Form   * Required Fields Personal Info Group Name* Today's Date Your Name* Nickname Home Address* City* State* Zip* Phone Number* Fax Email Address* Departure City Dates of Travel Emergency Contact Info Emergency Contact* Relationship to You* Phone Number* Address*

Please Answer These Questions Any specific medical issues (including any allergies)?*  yes no How is your physical condition? Do you have any dietary issues?*  yes no What are you most looking forward to about your Costa Rican Adventure? How did you hear about us? Have you signed the waiver?*  yes no   (Thank you and we look forward to seeing you in the near future! Please send your deposit to the address below. You may include this form with your deposit, submit it electronically by clicking the "Submit" button above, or fax it seperately to the number below. Feel free to Contact Us with any questions or comments.)   Back to Top   Costa Rican Adventures 2002 Addison Street, Suite 202 Berkeley, CA 94704 Phone: 800-551-7887 Fax: 510-649-1000 info@costaricanadventures.com