ARISING QUEEN

September 20-30,2013 held in Spain and Morrocco

$5563.00 per person



Please fill out a registration form for each person attending.

Contact Information
As it appears on your passport

*Last Name: Middle Name:

*First Name:


*Email: Secondary Email:


*Home Phone: Cellphone: Work Phone:


Street Address: City:


Prov/State: Postal Code/Zip:

Special Dietary Requirement

Special Requests


$1000.00 deposit to be paid by July 31, 2013

Balance of Payment to be paid in full by August 19, 2013