Registration-Victory Voyage Cruise

Registration Form
Victory Voyage 2010
February 20-25, 2010
Gospel Music Cruise To Progreso, Yucatan & Cozumel, Mexic0

NAME___________________________________DATE OF BIRTH________________________

ADDRESS______________________________________________________________________

CITY_____________________STATE/ZIP__________________PHONE____________________

PLEASE LIST THE NAMES AND BIRTH DATES OF THE PEOPLE IN YOUR CABIN BELOW:

___________________________________ ____________________________________

___________________________________ ____________________________________

___I have attached the check payable to VICTORY VOYAGE
for the $100 deposit per person to secure my cabin I selected on
the right.
___I have provided credit card payment payable to VICTORY
VOYAGE for the $100 deposit per person to secure my cabin I
selected on the right.
CREDIT CARD INFORMATION: ___VISA ___MASTERCARD ___DISCOVER ___AMEX

NAME AS IT APPEARS ON CARD__________________________________________________

CARD NUMBER_________________________________________EXP DATE_______________

CARDHOLDER SIGNATURE_______________________________________________________

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PLEASE PRINT THIS FORM OUT, COMPLETE IT AND RETURN WITH DEPOSIT TO:
VICTORY VOYAGE
PO BOX 147
KENNEDY, AL 35574
205-662-4826/205-596-4371