Registration Form
Ventures Birding International Tours
Tour *
Name *

First
Last
Email *
Address *

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Phone Number *
Gender
 Male 
 Female 
(This is for Room-Mate Selection if Required on Longer Tours)
Second Person's Name
Only One Form is Needed if Both People Live at Same Adrress

Emergency Contact Person:

Name
Relationship
Phone Number

### 		-
### 		-
####
Email

General Information:

Preferred Way to Contact You? *
 Phone 
 E-mail 
 Mail 
Would You Like for Us to Send You a Flyer, Itinerary & Birdlist from Previous Tour?
 Yes 
 No 
(The Information is Exactly the Same as on Our Website)
Are You a Smoker?
 Yes 
 No 
Do You Have any Difficulty Walking
Regular Trails?
 Yes 
 No 
If Yes, Please Explain
How did you Learn
About Ventures
Birding Tours?
Have You Traveled
with Ventures Birding Tours Before?
 Yes 
 No 

A Separate Health & Interest Form will be Sent to all Folks Joining Us on Longer Tours.

Rooming Details

I Would Prefer
a Single Room
 Yes 
 No 
(You Will be Charged the Single Supplement)
I Would Like to
Share a Room
 Yes 
 No 
(You Will be Charged the Single Supplement)
I Already Have a Room-Mate
 Yes 
 No 
(If We can not Find You a Suitable Room-Mate You Will be Charged the Single Supplement)
Room-Mate Name

First
Last
Special Needs
Are There any Other Details You Require?

Flight Information

For Many Years Ventures has Used Cathy King at Holiday Travel in
Winston-Salem for Our Travel Arrangements.
Cathy has all of the Information on Our Upcoming Tours &
Should You Wish for Her to Help You Out Her Details are:
E-Mail: adventuretrips@hotmail.com
Phone: 888.850.9254
I Wish to Make My Own Travel Arrangements
 Yes 
 No 

Please Remember to Let the Ventures Office

Know all of Your Travel Details.

Passport Information

Name

First
Last
Nationality
Date of Birth
Passport Number
Date & Place of Issue
Expiration Date

Person 2 Passport Information

Name

First
Last
Nationality
Date of Birth
Passport Number
Date & Place of Issue
Expiration Date

Each Participant will be Sent & Asked to Sign a Disclaimer
& Assumption of Risk & Liability Release Agreement

After You Submit this Form, You will be Directed to Reserve & or Pay for Tour.
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