MINA CLAVERO 2000 - Registration Form

PLEASE SEND THIS FORM BY FAX TO: +(54) 3544- 472091
OR BY E-MAIL A: contic@traslasierra.com
Subud Argentina. Att. Adela Conti

Name (as in passport) .................................................... Subud Name............................. Age .......... Address ....................................... ZIP ........... City ..........................
State ...................... Country ......................... Phone..................................... Fax.............................. Email................................................ Sex (M/F) .............
I'm delegate for .............................................. and Volunteer for .....................................................

Accompanied by (detail legal name and ages)
1 ...................................... 2 ............................................
3 ...................................... 4 ............................................

Registration Prices in Argentine Pesos ($ 1 = u$s 1 dólar).

Adult (from 17):
$ 135,00 if paid before Oct. 11th for .......... person/s sub-total $ .............
$ 150,00 if paid before Nov. 11th for .......... person/s sub-total $ .............

More than 12 years old:
$ 40,00 any time for .......... children/s sub-total $ .............

Under 12 years old: Free.

Total Registrations $ .............

Transportation
By air to Cordoba Airport ........ or by land to Mina Clavero directly ..........
Arrivals: Date ..................... Time ............... Transport: Air/Bus/Car Flight #: ........
Departure: Date ..................... Time ............... Transport: Air/Bus/Car Flight #: ........
If comanions travel separately attach detail of theirs arrivals and departures

Transfer from Airport, City of Cordoba to hotels at Mina Clavero (150km/2h 30´)
Only during arrivals days 10th and 11th Nov. and departures days 20th and 21st Nov.
One way: $10 for ........ person/s sub-total ........ Round: $20 for ........ person/s sub-total ........

Total Transfer $ .................


Lunch: Catering served at Subud Centre for lunch only between Nov. 11th and 20th.
Each lunch: $ 8.00, for .......... days, for ........... person/s sub-total $ .................
Children under 12 : $ 4.00, for .......... days, for ........... person/s sub-total $ .................
Children under 3, Free.

Total Lunch: $ .................


Dinners: Attendants may have dinner at town which offers great variety of restaurants.

Subtotal: $ .................
Charges for Bank Transfer $ 5 : $ .................
If paid whith credit card add 4% : $ .................
Total Payment: $ .................

BANK TRANSFERS:
Paid in USA Dollars or Argentine Pesos by bank transfer to:
Asociación Subud Argentina, Account Nº 14272/04, Bank name: Banco de la Provincia de Córdoba (National Bank #: 020), Sucursal Mina Clavero (NºSucursal: 338), Swift Code: CORDARBA, address: San Martín 1580 (5889) Mina Clavero, Córdoba, Argentina.
NOTE 1: Bank transfer charges by the registrant.
NOTE 2: Add $5 to the total value you will transfer (local bank charge).
NOTE 3: Attach copy of your bank transfer receipt to this form.

CREDTI CARD: This payment option will be done through ISC. Fill this form:

I will pay with: VISA ........ ó MASTERCARD .......... for the total amount US$: ................
(this should include the 4% for bank charges)
Card number: ............................................. Exp. Date: .......................
Name as appear on Card
................................................................................
Billing address:
................................................................................
Signature:

................................................................................
Phone / Fax / E-mail : ................................................................................
Passport number: ...........................................................................

IMPORTANT:
In case you pay with credit card fax a copy of this form to ISC: +62 361 463667 ,
and to Mina Clavero: +54 3544 472091.

HOTEL RESERVATIONS
Once registration payment has been done
Hotel payment must be payd in full on the day of arrival

Option 1: Breakfast, bath and shower, heating, air conditioning, phone and T.V.
Single room ($34 per person) Nº Nights: ........... = $ ............
Double room ($17 per person) Nº Nights: ........... = $ ............ Smoker: No / Yes
Extra bed ($17 per person) Nº Nights: ........... = $ ............ Smoker: No / Yes

Option 2: Breakfast, bath and shower, heating, kitchen and pool,
Apartments ($15 per person) NºNights: .......... x Nº Person/s (2 to 6) ........... = $ ............. Smoker: N / Y

Option 3: Breakfast, bath and shower.
Rooms ($13 per person) NºNights: .......... x Nº Person/s (2 to4) ........... = $ ............. Smoker: N / Y

Note:
I would like to share my room with. ..................................................... Assign me a roommate N / Y

All prices are per person / bed per night
Order of reservations will be respected

Camping:150 meters from the Subud Centre.
Services Include: Bathrooms, showers, hot water, barbecue, meters from the river.
Bring your own tent.
Prices per day per person: $ 3. Nº Person/s ........ Number of tents ............




SEND THIS FORM BY FAX TO: +(54) 3544- 472091
OR EMAIL TO: contic@traslasierra.com
Subud Argentina. Att. Adela Conti