Sacred Earth Journeys JAIPUR, INDIA
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    In order to submit this online registration you need to complete two steps:

    Step 1: Complete this Registration form
    Step 2: Complete the Terms and Conditions Agreement


    If your registration was submitted successfully our system will send you an email containing a copy of your registration for your records. 


    Sacred Earth Journeys - Secure Area
    We take every possible step to make sure that your data is kept safe

    Our registration area uses Secure Socket Layers (SSL), an advanced Internet security system, to protect the data you provide. For security purposes, all your registration information (including your name, address and credit card number) is encrypted using a protected server; as a result, your credit card and billing information is secure on its way to processing and approval.

    Print Registration and Terms & Conditions  Form

    TOUR NAME 

    Tour Start Date (dd/mm/yy)
      /   /   

      Tour Return Date (dd/mm/yy)
      /     /  

    HOW DID YOU HEAR ABOUT US?

    Sacred Earth Journeys Website  From another website?
     If yes, how did you hear about our website?  If yes, which website :
     
    An Event I attended Search Engine?
    If so, which event? If yes, which search engine?
     
    Word of Mouth Newspaper/Magazine
    If so, what is the person's name? If yes, which newspaper/magazine?
     
    Other
     
    PARTICIPANT # 1
    Name (Important: Name as it appears on your passport)
     
    Contact Information
    Street Address
     
    City   Province / State    
       
    Postal / Zip Code     Country   
         
    Date of Birth     Place of Birth  
         
    Phone (Day)     Phone (Evening)
       
    Email Address    
         
         
    Passport Information
    Passport Number:   Nationality: 
         
    Date of Issue:     Place of Issue:  
         
    Date of Expiry:     Profession:
         
         
    Emergency Contact Information
    Name:   Phone: 
         
    Email:    
         

    PARTICIPANT # 2
    Name (Important: Name as it appears on your passport)
     
    Contact Information
    Street Address
    City   Province / State    
     
    Postal / Zip Code     Country   
     
    Date of Birth     Place of Birth  
     
    Phone (Day)     Phone (Evening)
     
    Email Address    
       
         
    Passport Information
    Passport Number:   Nationality: 
     
    Date of Issue:     Place of Issue:  
     
    Date of Expiry:     Profession:
     
         
    Emergency Contact Information
    Name:   Phone: 
     
    Email:    
       

    SPECIAL DIET

    I require a special diet, or the following special services:  
    No
    Yes (Please describe below)

    TRAVEL INSURANCE
    We strongly recommend purchasing Tour Package Insurance (cancellation & medical insurance) to protect against cancellation fees and additional travel/medical expenses that may incur before, after or during the trip.

    Travel Insurance for Canadian residents depends on age and length/cost of trip, so please ask us for a quote prior to registering, or indicate below that you would like a quote from us.

    We are not able to offer travel insurance to citizens/residents of countries other than Canada.

    Yes, I plan to purchase trip insurance through Sacred Earth Journeys and/or their agents.
       
    No, I decline to purchase trip insurance through Sacred Earth Journeys and/or their agents.
       
    I will be purchasing trip insurance through my local agent.
       
    ACCOMMODATION (included in Tour)
    I would like a

    Double Room    Single Room     I would like to find a roommate

    * The single supplement is for those who would like to secure a private room throughout the tour, at the indicated additional price. If you are not traveling with anyone you know and would like to share a room, please indicate your preferences for a roommate above. We will be happy to work to find you a suitable roommate.

    ADDITIONAL ACCOMMODATION (before and after Tour)
    Please arrange accommodation for the following:
    City
    Arriving
    Departing
    City
    Arriving
    Departing

    PAYMENT OPTIONS

    Deposit (US $400 for all trips except Adventure Travel trips - US $550)

    Final Payment (due 70 days prior to departure) 

    Payment in full (due if you are booking within 70 days of departure)


    Personal Cheque sent via regular mail  (check made out to Sacred Earth Journeys and mailed to Sacred Earth Journeys, Suite 220 - 133 E. 8th Avenue, Vancouver, B.C. V5T 1R8 Canada)
     

    Bank Draft sent via regular mail (draft from your bank, made out to Sacred Earth Journeys and mailed to Sacred Earth Journeys, Suite 220 - 133 E. 8th Avenue, Vancouver, B.C. V5T 1R8 Canada)
     

    I would like to pay by Visa. (we accept Visa only and there is a 2.5% in-house admin fee for Visa payments)

    a) Please contact me by telephone for Visa credit card details

    b) I am advising my Visa credit card details.

    Visa Number
    Date of Expiry
    Name on Credit Card

    I authorize Sacred Earth Journeys to debit my Visa credit card in the amount of
    USD $.00

    Representing:
    Deposit

    Final Payment
    Payment Full

    Important: Enter a valid email account below. Our system will email you a complete copy of your registration shortly after the terms and Conditions Agreement is submitted. 

    Email Address:
     

    Date:
     
     

     

     

    Sacred Journeys | Wellness Travel & Yoga Retreats | Independent India Tours
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    Sacred Earth Journeys
    Ste 220 - 133 E. 8th Ave. Vancouver, B.C. V5T 1R8 Canada
    Tel: (604) 874-7922, Toll Free 1-877-874-7922
    info@sacredearthjourneys.ca

     
     
    Photographs by Peter Langer.

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