Registration Form

Coco Bay Estates, Costa Rica Booking For:[ ] March 24 - 31, 2012 Instructed by Shay McKelvey, San Diego CA[ ] April 21 - 28, 2012 Instructed by Alexa Zaledonis, Annapolis MDName: ________________________________________________________________

Address: ______________________________________________________________

______________________________________________________________________

Email Address: ________________________________________________________

Phone: _______________________________________________________________

Room Type: [ ] Regular Single, full or queen bed, private bath: $1800 [ ] King Single, private bath $2100 [ ] Double - twin beds $1550 [ ] Double - king bed (shared) $1550If double, who is your roommate? Name: ___________________________________

(If you don’t have one, we can assign one for a twin bedroom only)

Is there anyone you want to share a condo with? ___________________________

______________________________________________________________________

$500 deposit due with registration to hold your spot; 50% due January 31; balance due 14 days before arrival. May be paid by check, credit card or wire transfer. Credit

card and wire transfer instructions available online at www.jetawayfit.net

Checks and registration may be mailed to:Marie Dall’Acqua

238 King George StreetAnnapolis, MD 21401

or, scan and email to [email protected] 410-353-1552

JetAwayFit Registration Form - April 21-28, 2012