Registration form

Back to brochure Amazing Ecuador & the Galapagos Islands

March 29 - April 5, 2008

(Just print this page out and Fax (412) 344-3937, copy and paste it into an email, or mail it in.)

Name:_________________________________________ Birth Date ____/_____/______ [ ]Male [ ]Female

(as it appears on your passport)

How would you like your name to appear (informally) on our group passenger list______________________________________________

Street: ____________________________________________________________ Apt # _________________

City/State ________________________________________________________ Zip ___________________

E-Mail____________________ Phone: H _________________ W __________________ C __________________

T-shirt Size: [ ] S [ ]M [ ] L [ ] XL

ACCOMMODATIONS:

[ ] Single Occupancy

[ ] Double Occupancy* Roommate Request _______________________________________________

*Roommate Matching Available Upon Request

AIR TRAVEL:

[ ] Please sign me up for Amazing Journeys group round-trip air from Miami to Ecuador ($699 including all taxes and surcharges).

[ ] Please sign me up for Amazing Journeys group business class round-trip air from Miami to Ecuador ($1060 including all taxes and surcharges).

[ ] I Prefer to make my own flight arrangements* Please add $100 for round-trip transfers for those arriving and departing at same time as group flight.

*Please note - If you are arriving or departing on flights which are not when the group flights arrives or departs, you must make your own

transportation arrangements between our arrival city and Otavalo, and our departure city and the airport at Guayaquil.

Trip Cancellation Insurance is optional but HIGHLY recommended. Info will be sent out with your confirmation.

PAYMENT:

[ ] Enclosed is my deposit of $500 (full payment due by 1/22/2008)

or, [ ] Enclosed is my full payment: $________________ (make check payable to Amazing Journeys)

Charge my: [ ] Visa [ ] Master Card [ ] American Express [ ] Discover

Acct.# ________________________________________________ Exp.Date _____________

3 or 4 Digit Security Code ______________________

Signature _____________________________________________________

[ ] Check here if you prefer NOT to have your name, phone number and email on the Group Passenger List.

How did you hear about this trip? ____________________________________________________________

I've read, understand and agree to abide by all terms, conditions and information stated in the brochure and the Responsibility Clause set forth below:

Signature:_______________________________________________________ Date:_____/_______/_____

QUESTIONS AND REGISTRATION:

Call: Amazing Journeys at (800) 734-0493 or (412) 571-0220

E-mail: info@amazingjourneys.net

Mail: Amazing Journeys, 733 Valleyview Road, Pittsburgh, PA 15243

Fax: Amazing Journeys at (412) 344-3937 Visit: www.amazingjourneys.net

Responsibility. By signing our reservation form, you agree to the following: Amazing Journeys , LLC acts only in the capacity of agents for Collette Vacations, Klein Tours, Galapagos Legend and the suppliers of the travel services named in your itinerary or otherwise providing service in connection with this trip (“the Suppliers”), including cruise lines, airlines, hotels, sightseeing tour operators, bus lines, shore excursion companies, and providers of entertainment. We assume no responsibility for any personal injury, property damage, or other loss, accident, delay, inconvenience, or irregularity which may be occasioned either by reason (1) any act or omission of any of the Suppliers (2) any matter beyond our exclusive control including but not limited to a delay or cancellation of a flight that causes the participant to miss any portion of the trip. We do not guarantee any prices or the quality of any services. We have no special knowledge regarding the financial condition of the Suppliers, unsafe conditions, health hazards, weather hazards, or climate extremes at locations to which you may travel. For information concerning possible dangers at destinations, we recommend contacting the Travel Warnings Section of the U.S. State Department at (202) 647-5225 or www.travel.state.gov and click on “Travel Warnings.” For medical information, we recommend contacting the Centers for Disease Control at (877) FYI-TRIP or www.cdc.gov/travel. You assume full and complete responsibility for checking and verifying all passport and visa requirements of the destinations, as well as the conditions regarding health, safety, security, political stability, and labor or civil unrest at such destinations. We reserve the right to change the itinerary of the trip, delete and/or substitute cities to be visited, change the class of service and the mode of transportation, all without prior notice, to the extent that such services and accommodations offered cannot be supplied due to delays, unsuitability, mechanical problems, weather, change of ownership or other causes beyond our exclusive control. Any additional costs will be borne by you. We further reserve the right to withdraw the trip prior to the date of departure. Further, we reserve the right to decline to accept or decline to retain any participant should such person's health or deportment impede the operation of the trip or enjoyment of any other participant. In such case, a refund of unused land tour services is the limit of our liability should such person be required to depart the trip. You agree that we may use photographs of you taken on this trip for publication on our website or in marketing material. The rights and remedies made available under this agreement are in addition to any other rights and remedies available under applicable law. However, we offer refunds under this agreement with the express understanding that the receipt of that refund by a passenger waives the additional remedies, and under no circumstances will be responsible for damages in excess of the amount paid to us by you. All claims must be submitted within 30 days after return of the trip. Any dispute arising out of or in connection with this agreement shall be determined solely by the courts in Pittsburgh, Pennsylvania, and the participant hereby consents to the jurisdiction of said courts.