Pre Registration ~ Biodanza World Cruise 2019
Email address *
How many people do you like to register? *
Person 1
First Name - Person 1 *
Nombre de pila / ファーストネーム / Prénom / Nome
Your answer
Last Name - Person 1 *
Apellido / 苗字 / Nom de famille / Cognome
Your answer
Email - Person 1 *
Eメール
Your answer
City - Person 1 *
Ciudad / シティ / Ville / Città
Your answer
Country - Person 1 *
País / 国 / Pays / Nazione
Your answer
Male / Female
Date of Birth
MM
/
DD
/
YYYY
Biodanza experience
Your answer
Person 2
First Name
Your answer
Last Name
Your answer
Email
Your answer
City
Your answer
Country
Your answer
Male / Female
Date of Birth
MM
/
DD
/
YYYY
Biodanza experience
Your answer
Roommate?
Looking for Room mate? *
Male
Female
if YES
Same accommodation category
More expensive accommodation category is OK
Less expensive accommodation category is OK
His/her choice of Accommodation type
Accommodation
Choice of Accommodation *
Interior Hut (€956)
Ocean View (€1034)
Boardwalk View Balcony (€1034)
Ocean View Balcony (€1204)
Accommodation
Payment
Payment
We charge 4% for credit card and 5% for Pay Pal transactions
Bank Transfer (no extra costs)
Credit card (+4%)
Pay Pal (+5%)
Person 1
Person 2
Agree to Terms & Conditions *
By registering you agree to the terms and conditions of this Biodanza World Cruise. Do you agree these [link to terms & conditions] ?
Yes
No
Person 1
Person 2
Communication
Language of communication *
Lengua de comunicación / 共通語 / Langue de communication / Lingua di comunicazione
Required
Do you have a question or suggestion?
¿Tiene una pregunta o sugerencia? / あなたが質問や提案を持っていますか ? / Avez-vous une question ou une suggestion? / Avete una domanda o suggerimento?
Your answer
A copy of your responses will be emailed to the address you provided.
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