HERITAGE CARAVAN 2019 - REGISTRATION FORM
Trip Duration: March 2nd to 9th, 2019
Trip Coverage: 8 Regions
Phone Number: 0205973973 Email: promo@omnimediagh.com
Full Name *
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Date of Birth
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Preferred Name for TAG *
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Gender *
T-Shirt Size *
Email *
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Profession *
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Address (Home) *
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Personal Mobile Number(s) *
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Emergency Contact Number(s) *
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Registration Fees: All fees (listed in GHS) include transportation, accommodation (Bed+Breakfast+Dinner), entrance fees for tour sites and special activities. Please check appropriate registration fee. NB: Fees will be refunded less 20% of registration fee, if cancellation or change resulting in refund is received in writing no later that February 19, 2019. All refunds will be processed after the tour. After February 19, fees are non-refundable. Substitutions are allowed at no charge. *
Payment Method: Payment/registration confirmation/receipt and further information will be required upon submission of forms. *
I understand that I will have to pay the above-mentioned fee before February 15, 2019 to make me eligible to go on the Heritage Caravan *
Required
Payment Details
Bank: Ecobank
Branch: Head Office
Account Name: Omni Media Company Limited
Account No: 0010014402488101
Swift Code: ECOCGHAC

Mobile Money Number: 0550900006

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