Registration for Leonids Meteor Storm Expedition, 2001 Nov. 14-20

Information/Connecting flights/Options

Please print this form to fax or mail your registration.

Name(s): _________________________________________________ as on passports

____________________________________________________

Address: ___________________________________________________________

_________________________________________________________________

Day Phone: __________ Eve Phone: __________ E-mail: _________

This reservation is for ____ person(s). I (we) wish to share a room with ____ other person(s). Please consider the criteria below for my (our) roommates. (You may specify roommate(s) by name, or we can match people by sex & smoking preference.)

________________________________________________________________

Airline preference: Asiana___ Continental___ Making own arrangements___

Hotel preference: Sun Route___ Condo___ Outrigger: Standard Ocean View___

Outrigger: Deluxe Ocean View___ Ocean Front___ Voyager Club Ocean View___

Connecting flights needed from ____________________________ airport.

Interested in Extension Trip to: ____________________________________

Interested in Travel Insurance? (separate payment required) Yes__ No__ Maybe__

“I have read and understand the disclaimers for this expedition, and I (we) agree to those conditions.”

Signature: ____________________

SEND THIS FORM with full payment to:

                                                                                                    Eclipse Edge Expeditions/L01
                                                                                                    PO Box 15186
                                                                                                    Chevy Chase, MD 20825-5186

Registration for Leonids Meteor Storm Expedition, 2001 Nov. 14-20

Payment and ID Badge Form

[Entries below describe payment for one registration code, corresponding to one hotel room. Others paying separately who will share the same room should fill out a separate form. Please send multiple forms if paying for more than one registration code.]

Name(s):_________________________________________________________

(give names and city exactly as they should appear on ID badges during the expedition; include ages of children under 12)

___________________________________________________________

City (for ID badges on expedition):_____________________________

Deposit at $500 per person (circle one): Single Double Triple $_______

Comments or special considerations:____________________________

_________________________________________________________

________________________________________________________________

Credit card coupon for payments:

Payments may be made via check or money order drawn on a U.S. bank, or by Visa or MasterCard credit card. Your authorization for credit card payment may be made by phone (360/504-1169), fax (866/758-3792), mail (this form), or E-mail (tomvf@metaresearch.org). For credit cards only, please include the following:

______ ________________________ _________ _______________________

Amount Credit Card # Exp. Date Signature

Mail to:                                                                              Eclipse Edge Expeditions/L01
                                                                                            PO Box 15186
                                                                                           Chevy Chase, MD 20825-5186