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initiation trip to Peru

NAME: (As It Appears Exactly On Passport) *

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I Am Willing To Share A Room With A * FemaleMaleEither

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A single supplement requires 20% addition to the trip cost.

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TRIP #

DEPOSIT $ 500

Full Amount USD $

Trip #_________, 20___(Year) Hatun Karpay led by Elizabeth B. Jenkins

Check dates carefully; failure to pay on time may disqualify your trip participation.
Full payment due 65 days prior to travel date.
All participants required to carry full Emergency Medical Insurance.

PAYMENT METHOD: CHECK ENCLOSED (Payable to Wiraqocha Foundation

NOTE: Check paying customers in addition to submitting this form electronically, please print this form out and mail with check to:

WIRAQOCHA FOUNDATION
PO BOX 500
NA'ALEHU, HI 96772

(808) 929-7370

THANK YOU.

If you have further questions or concerns please don't hesitate to contact us through our CONTACT INFO Page.

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initiation trip to Peru

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