WEINBERGER HOLDINGS PTY LTD.

Director: Dr Dianne & Dr Peter Weinberger.
19 Donegal Crescent.
Sorrento, 4217
Queensland.
Australia.
Phone/Fax: 61 75 5398769
E-mail: isis@onthenet.com.au
www.crystal-healing.com

Registration for 13 day tour to Egypt
Land costs only: Per person in US dollars: Double occupancy: $1,675.Single: $2,175.
Passenger information.

Last name_________________________First name______________________________

Address____________________________________________________

___________________________________Country______________zip code________

Phone_________________________Fax_________________Email_____________

Name and contact in case of emergency____________________________________________

Phone__________________________

Single request___________________________Double request_________________________

Payment information

Money orders and cheques made payable to Weinberger Holdings Pty Ltd.

Authorised payment amount: $______________________________________________

Signature__________________Date_____________________________

Passport number________________________Expires_________________________

Terms and conditions agreement.

I have read and agreed to the terms and conditions for this tour.

Signature______________________________date__________________________