Kuchipudi Indian Classical Retreat with Hari Om

Registration Methods :

Please complete ONLINE registration form below.

Fields marked * are required.

First Name:*

Last Name:*

Pure Card No. (if applicable):*

Gender:*

	Male
	Female

City:

Mobile:*

Other Contact No.:

Email:*

Confirm Email:*

Emergency Contact Person & Number:

ACCOMMODATION

* If you have a partner for a Twin Share room, please indicate partner’s name upon registering
* Partners must also submit a separate registration.
* If you have no indicated partner, the Twin-share option will be subject to availability only.

Type	Early-Bird(10%) Ends 30 June 2011	Regular Price
Kuchipudi Indian Classical Retreat Single Occupancy	HK$21,229	HK$23,588
Kuchipudi Indian Classical Retreat Twin Share Occupancy	HK$16,999	HK$18,888
*Effective 1 June 2011, an additional HK$188 applies to the above prices due to the increment of Tax & Fuel Surcharge.
Partner Name:

PERSONAL DETAILS FOR FLIGHT TICKET:
Your Full name as shown on passport:*
Your Date of Birth:*
Your Passport Number:*
Your Passport Issuing country:*
Your Passport Expiry Date:*
I declare that all the above information is complete and correct. I understand that any changes made after ticket issue will be subject to a penalty by the airline.

TO CONFIRM YOUR REGISTRATION

1. You will receive a Confirmation Email from the Events Department of Pure within 3 business days after your registration is submitted successfully

2. Payment must be received fully to In Travel Ltd. within 7 days of Confirmation Email sent

1. Any injuries or physical concerns? If so, please specify:

By submitting your application, you agree to the following Terms and Conditions*

	Yes
	No

Please type the code shown in the above image: (four digit number - no spaces)