The International Academy of Vibrational Therapies

In Conjunction with

Weinberger Holdings Pty Ltd & Abu Simbel Travel Giza Egypt

Journey 1^st July to 14^th July 2005

Land costs only in US Dollars: $3,660

Per Person Double occupancy:

Last name____________________________First name___________________________

Address_____________________________________________________

__________________________________Country_________________________zip code_______________

Phone ____________________Fax_______________Email_______________________________

Name and contact number in case of emergency. Name____________________Phone______________

Are you coming with a Roommate? If so name: ___________________________

Single request______________Double request___________ Are you a smoker__________

Do you have any disabilities or health issues? (Please attach…All information is collected in accordance with the Privacy Policy

Payment information

Credit card details: American express and Diners not accepted.

Amount____________________Cardnumber_________________________expirydate_________________

Money orders and cheques payable to Weinberger Holdings Pty Ltd.

Authorized Payment Amount: $_______________________________

Passport number____________________________ Expires_______________

Terms and Conditions agreement

I have read and agree to the Terms

Signature____________________________________________________Date________________________