|SECTION A: DELEGATE INFORMATION|
Name of participant(s)
Couples and families, where one person is paying the bill for all and all details are identical, may put all names on the one form. BUT groups of friends who are paying separately *must* complete a separate form for each person. If you would like randomly allocated room-mate(s) tick here: If you wish to share with friend(s) sending separate form(s) give their names:
I will require shuttle bus from airport to Costao. Please include US$14
for return ticket, and info re your flights below (or send later if not
I will be bringing a child/ children to the event, please give age(s) (see note 5 )
My diet is vegetarian vegan rawfood - All meals at the Congress will be vegan but may not be on the tours, completion of the above will help us plan for your requirements.
I require simultaneous interpretation and my language is:
SECTION B: FEES
Payment must be made in full, and is accepted by cheques in US dollars, euros, sterling or credit card.
SECTION C: METHODS OF PAYMENT
Cheques, in US dollars, euros or sterling only, may be accepted but must be cleared prior to the deadlines in order to guarantee a place and should be made out to "Sociedade Vegetariana Brasileira".
I enclose cheque
to the value of
(£ $ or euros)
If you wish to pay by credit/debit card - Visa/Mastercard/Amex/Switch/Delta please fill in the form below.
Payment by credit card can be sent by mail or fax – please do not email credit card details as the Society cannot be responsible in case of misuse by a third party.
Any cancellation 60 days prior to Congress will incur in a charge of 50%
of the amount payed, 30 days in 70%. Fees cannot be refunded less than
30 days before Congress.
Please send completed forms and payments to
|COSTÃO DO SANTINHO RESORT
"OFF-LINE" CREDIT CARD DEBIT AUTHORIZATION
I am authorizing a debit from my credit card number:
ACCEPTED CREDIT CARDS:
( ) American Express ( ) Mastercard ( ) Visa
Exp.Date: Credit Card holder:
The amount of: US$ in order to guarantee the reservation in the name of :
Number of guests/Apartment type:
Check-in date : - **After 3pm
Check-out date: - **Until 11am
Client signature: _________________________________
Note: Please return this with a copy of your Credit Card and Passport
by fax to: 48 269 8599