Where the moon mates the sun Booking Sheet for Program 4 NEW: 36 Hours with Eclipse-City to Siberia PERSONAL DETAILS (Please fill out your details. People accompanying you shall fill out Page 2)

Middle Initial

First Name:

Second Name:

Born on d/m/y:

Gender: Male o Female o

in: City/Country:

Passport Number:

Nationality:

Passport Issue Date d/m/y:

Issued in (city):

Passport valid through d/m/y:

Please do also provide a scanned copy of your passport and send this to [email protected] for your visa invitation

CURRENT ADRESS

Street

ZIP Code

City

Country

Telephone

e-mail

NAME OF PERSON WE SHOULD CONTACT IN CASE OF EMERGENCY (for you and accompanying travellers)

Full Name

TRAVEL DETAILS

Relationship (spouse, mother…)

Phone (incl. Prefix)

I want to book program code (all prices in Euro)

Program 4: 36 Hours to Siberia Program 4 Supplemental Business Class Seating Program 4 ITB PROMO* Supplemental Gala Dinner

Number of travellers

Price / Person 1.590,00 € 599,00 €

Total 99,00 €

999,00 € 99,00 €

Total *) Valid only through March 31, 2007 I HAVE READ AND ACCEPT ECLIPSE-CTY'S TERMS AND CONDITIONS PUBLISHED ONLINE (APRIL 2007)

Full Name / Date and Place / Signature

Please (a) sign this document AND (b) fax it or email it to us Upon receipt of your booking, we will send you an invoice

Booking Sheet

www.eclipse-city.com [email protected] / Fax:+49 6173 324579

Page 1 of 2

Eclipse City Limited 5 Jupiter House, Caleva Park - Aldermaston, Reading - Berkhire RG7 8NN, United Kingdom

(2nd)

PERSONAL DETAILS (People accompanying the main traveller)

First Name(s): Gender: Male o Female o Nationality:

Middle Initial

Second Name:

Born on d/m/y:

in: City/Country:

Passport

Passport Issue Date d/m/y:

Issued in (city): Passport valid through d/m/y: (3rd)

PERSONAL DETAILS (People accompanying the main traveller)

First Name(s): Gender: Male o Female o Nationality:

Middle Initial

Second Name:

Born on d/m/y:

in: City/Country:

Passport

Passport Issue Date d/m/y:

Issued in (city): Passport valid through d/m/y: (4th)

PERSONAL DETAILS (People accompanying the main traveller)

First Name(s): Gender: Male o Female o Nationality:

Middle Initial

Second Name:

Born on d/m/y:

in: City/Country:

Passport

Passport Issue Date d/m/y:

Issued in (city): Passport valid through d/m/y: (5th)

PERSONAL DETAILS (People accompanying the main traveller)

First Name(s): Gender: Male o Female o Nationality:

Middle Initial Born on d/m/y:

Second Name: in: City/Country:

Passport

Passport Issue Date d/m/y:

Issued in (city): Passport valid through d/m/y:

Please do also provide a scanned copy of your passports and send these to [email protected] for your visa invitation

I HAVE READ AND ACCEPT ECLIPSE-CTY'S TERMS AND CONDITIONS PUBLISHED ONLINE (APRIL 2007)

(2nd) Full Name / Date and Place / Signature

(4th) Full Name / Date and Place / Signature

(3rd) Full Name / Date and Place / Signature

(5th) Full Name / Date and Place / Signature

Booking Sheet

www.eclipse-city.com [email protected] / Fax:+49 6173 324579

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