Family Summer Adventure in Guadalajara

Application for Enrollment

Upon Registration completion, you will be prompted to pay your non-refundable $450.00 registration fee online (will apply towards total amount) or via check. Please do not forget to fill out a health form for each family member traveling with the group. * Form will not submit if these fields are not completed. Please fill out form completely to guarantee your spot.

Family Name*
# of Members participating
	members total
Address*
City*
State*
Zip Code*
Country
Home Phone*
Fax
E-mail*

Mother's Name
Phone
Work Phone
E-mail

Father's Name
Phone
Work Phone
E-mail
Additional Family Members	(please list name, age & any allergies)

*If parents are separated, please state with whom student lives:
Applicant’s T-Shirt Size (free t-shirt!)	Small Medium Large X Large XX Large
Where did you first hear about us?

EMERGENCY CONTACT	(Other than parent, can be a relative or friend)
Name
Relationship
Address
City
State
Zip Code
Country
Home Phone
E-mail

Online Payment after form completion. I understand I am paying the $450 deposit securely online. (After form completion you will be redirected to PayPal to make payment via Credit Card or PayPal. Only Payment will guarantee your spot is reserved.) U.S Passport is required to travel to México. Our prices do not include airfare.

I certify that the above personal information and all other information given in this application packet is true and correct. Initial box:

Coco Aguirre R.
Director, Spanish 4 Me, LLC
404-474-2667
Atlanta, Georgia
coco@spanish4me.com
www.spanish4me.com

These pages have a few external links that are children friendly. However, the Internet is a place where web pages change often and we have no control over that. ALWAYS accompany your children when visiting new sites.

+ Los Mandatos
+ Games & Activities
+ El Alfabeto
+ Viva Mexico
+ Food / La Comida