Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Birthdate *

MM

DD

YYYY

Non-Refundable Deposit *

By checking the box I agree and understand that my $500 deposit is per person and the deposits are 100% NON-REFUNDABLE.

Airfare Policy *

By checking the box I agree not to purchase my airfare until explicitly told to do so in writing by Alchemy Adventures. By checking this box, I also acknowledge that if I purchase airline tickets prior to being instructed to do so and the trip is cancelled, Alchemy Adventures will not be held liable for money spent on airline tickets.