World Music & Dance Productions’

Mystical MOROCCO TOUR

March 13^th-26^th, 2010

Full Name (exactly as it appears on your passport please):

Address:

Home Phone #: Alternate Phone #: Work: Cell:

E-mail Address:

Are you an American citizen?

If not, what is your nationality?

Number & kind of Passport:

Payment method (please circle one) Check Cash CC:

If paying by CC: Visa Mastercard AMEX Discover

CC Number:

CC Expiration Date: CVV code (three digit # on back of card or four digit # of front of care for AMEX)

CC Billing Address:

Is this CC in your name? yes no

If no, name of CC holder and phone #:

Amount paid: please check appropriate categories.

****$100 DISCOUNT APPLIES IF SIGNING UP BEFORE 9/15/2009****PLEASE ADD 4% TO AMOUNT IF PAYING BY CC.

Deposit $750

Full Payment of $3495

Land Package: $2495

Single Occupancy Supplement: $485

Other Payment in the amount of: ________

**50% OF FULL PAYMENT AMOUNT IS DUE BY DEC 10^TH, 2009

**FULL PAYMENT IS DUE BY FEB 2^nd, 2010 AT THE LATEST.

**DEPOSIT INCLUDES A REGISTRATION FEE OF $500 THAT IS NON-REFUNDABLE.

**NO REFUNDS AFTER DECEMBER 10^TH, 2009.

Emergency Contact Information:

Name of Emergency Contact:

Phone #: Home Cell

Their relationship to you:

ANY CONCERNS/ISSUES THAT YOU MAY HAVE AND WE NEED TO KNOW ABOUT?

I ________________________ have reviewed the brochure for this trip, read, understood and agree with the terms of this agreement. I also agree to hold WMD Productions, Zein Al-Jundi, The Arabic Bazaar, Zein’s Dance Studio and all parties involved in the making of any of the event(s) associated with this tour free of liability of any harm and injuries that may result from my participation in such event(s).

Signature__________________________ Date _________________

**for help with connecting airline tickets to/from JFK, NY, please contact**

Ibrahim Fakhreddine @ The Travel Center, Austin TX (512) 250-1141

**PLEASE MAKE CHECKS PAYABLE TO WMD PRODUCTIONS**