2014, 2015, 2016 and 2017 Antarctica Marathon Tour ApplicationPRINT THIS FORM To reserve your space, please send a check for $300 per person to: Marathon Tours, Inc. C-5 Shipway Place, Boston, MA 02129 Waitlist me for 2014___ Waitlist me for 2015___ Waitlist me for 2016___ Confirm me for 2017____
Ship: Akademok Ioffe Cabin Type: Main Deck Triple___ Twin Shared___ Twin Semi-Private___ Twin Private___ Superior___ Shackleton Suite___ One Ocean Suite___
Passport Name (first and last) __________________________________ Marathon__ 1/2 marathon__ supporter__ Passport Name (first and last) __________________________________ Marathon__ 1/2 marathon__ supporter__ Address __________________________________________________________________________ City ______________________ State/Prov _______ Postal Code ________________ Country_____________ Day Phone __________________ Evening Phone ___________________ Flight Departure Home City ______________ Email____________________________________________ Passport Number___________________ Country of issuance_____________ Date of Birth____________ Passport Number___________________ Country of issuance_____________ Date of Birth____________ Fastest marathon time within the past 2 years of this application__________________________ Emergency contact name and phone________________________________________________
OPTIONS: Single person room (hotel only)____ Match me in a room with another runner____
Special Requests __________________________________________________________________ I have read and agree to the terms outlined under General Conditions. Signature(s)___________________________________________ Date _____________ |