English Name:                                                             Chinese Name:                      

英文姓名                                                                     中文姓名                              

Telephone:                                              Mobile:                                      Fax:

電話號碼                                                手提                                           電傳

Address:                                                                                                Postal Code:

地址                                                                                                      郵區號碼

Canadian Passport No.                                                 or  Other passport No.

加拿大護照號碼                                                               或其他護照號碼   

Occupation 職業 (如已退休, 請填未退休前職業 )          Date of birth: 出生日期       Place of Birth:出生地點

How many people are traveling together? What are their names?  有幾多人同行和他們的中英文姓名:

If you are traveling alone, do you require a single       Your preferred roommate's name:   與你同房姓名:    

room? (*costs extra)  Write yes or no

Do you intend to purchase Travel Insurance?                       Are you fit to travel for 17 days?                   Yes or No

你是否要買醫生,藥物和安全保險?  Yes or No                       你的健康和體力去十七天旅行 是安全的嗎 ?  

In case of emergency, who should be notified?  如發生意外，應該通知何人?  與該人有什麼關係?

I am applying to join the tour and I have read and understand the tour detail. I will obey all the rules & regulations. 我申請參加這旅行團，我明白全部行程，我將會尊守全部規則。

I am paying Can$500.00 as deposit for the tour with the application. I understand that if I withdraw from the tour, I will not be given back the deposit money (see Terms & Conditions).

連同報名表本人交上加金五百元定金，如我稍後退出，我知道這定金是不會退還給我的。

Signed: 簽名: _____________________________________        Date 日期:                                 , 2002.

*Please also read carefully & sign the "Release of Indemnity" form.   請小心閱讀英文"Release of Indemnity"文件的說明和簽字

Information in this application is considered "CONFIDENTIAL"