TRIP REGISTRATION FORM
NAME:
PHONE: EMAIL:
ADDRESS:
CITY:
STATE:
ZIP:
TRIP NAME:
DEPOSIT/PAYMENT: 

Please mail checks payable to:

  Cathy and/or Gordon ILLG
 P.O. Box 280668
 Lakewood, CO 80228-0668

 303-237-7086
ROOM PREFERENCE:    

SINGLE

DOUBLE

(SINGLE SUPPLEMENT APPLIES)

SMOKING

NON-SMOKING

NANPA MEMBER NUMBER/PSA CODE: (for discount)
DIETARY/SPECIAL CONCERNS, FAVORITE SNACKS/DRINKS:

WHERE DID YOU HEAR ABOUT US?

THANK YOU!!