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Registrant Information
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Affiliation:
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Facility Name or Group Practice
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Post-Title:
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For "Other" post-title, please note in Remarks section below. |
Specialty:
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Transportation
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Arrival Information:
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Offered on June 11 ONLY from Kona Airport
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Hotel Reservation
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Check-In Date:
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Use format MM/DD/YYYY; date you will arrive
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Check-Out Date:
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Use format MM/DD/YYYY; date you will depart
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Bed Request:
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Number of beds - Enter 1 or 2; hotel cannot guarantee
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Transportation
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Departure Information:
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Offered on June 15 ONLY to Kona Airport
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Full Guest Names In This Room
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Guest 1 or Self:
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Guest 1 Age:
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Enter age if under 18
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Guest 2:
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Guest 2 Age:
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Enter age if under 18
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Guest 3:
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Guest 3 Age:
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Enter age if under 18
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Final Payment Option on Unpaid Balance
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Package Balance Due*:
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Charge my credit card at your convenience
Charge my credit card on or after May 1, 2010
I will send payment by May 1, 2010
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Activity Choice (select one)
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Wednesday, June 14:
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Bike Mamalahoa/ Please note height and sandwich choice (TURK, HAM, RBEEF, TUNA, VEG) in remarks.
Dive Excursion/ Please note sandwich choice (TURK, VEG, HAM) in remarks
Dive Trip Snorkeler/ Please note sandwich choice (TURK, VEG, HAM) in remarks. Space is very limited.
Golf Hapuna/ 9 am Tee Time
Golf Mauna Kea/ 10 am Tee Time
Kayak/ Please note shoe size and sandwich choice (TURK, VEG) in remarks.
Massage @ Mauna Kea/ Note preferred time and choice of the following in remarks: Swedish, Lomi Lomi, Sports, Golfer’s, Reflexology, Eclectic, Sunburn Relief, Expectant Mother
Tennis Clinic
Waterfalls Excursion/ Please note sandwich choice (TURK, VEG, HAM, TUNA, RBEEF) in remarks. Separate fee for toddlers and infants (under 5).
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