Application

Bill Russell's Mountain Tours

3 Pratt Street

Essex, CT 06426

I am applying for the following MOUNTAIN TOURS trip. 

Trip Name ______________________________________________________

Depart Date ____________Return Date _______________Trip Number _____

Deposit $_____Fee $ ______Single Room $ ______Total Fee $ ___________

The balance of the fee is to be paid 50% 120 days before departure and the

final balance of 50% 90 days before departure. When we receive this completed

application, we will send you a confirmation and information to get ready for the

trip with maps and directions.

Name ____________________Address ____________________________

City _________________________________St _________Zip __________

Telephone:       Home_________________Office______________________

E-Mail________________________________________________________

Smoke Yes____No ___Your Profession ____________________Age ____

Where did you hear about us? ____________________________________

To allow us to make your air reservations, please complete the following:

Charge Card ________ Number ___________________Exp Date _________

Emergency Name ___________________Telephone ___________________

I prefer a roommate    Yes    No              I prefer a private room    Yes    No

If you request a private room, your cost will be increased $ 200/wk.

Please inform us if you have a preference for a roommate _______________

Preferred airline departure city:_____________________________________

Cancellation Policy

If the leader cancels a trip for any reason, you will receive a full refund.  If you must cancel up to 120 days before departure, you will receive a full refund less deposit. If you cancel 90 to 120 days before departure, you will receive a 50% refund of any moneys paid, less deposit. If you cancel within 90-60 days before departure, you will receive a 25 % refund less deposit. If you cancel within 60 days, there is no refund. We strongly suggest you take out trip insurance, so if you have to cancel for an acceptable reason, your fees will all be re-funded. Tours are subject to cancellation for non-payment of fees in a timely manner.