BEAUTY AND THE BEACH 2024 COSTA RICA - REGISTRATION FORM
PERSONAL INFORMATION
First Name
*
Last Name
*
Address
*
City
*
State
*
- - Choose One - -
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Best # to reach you?
*
Mobile or Cell Phone
*
Email Address
*
DOB (mm/dd/yyyy)
*
EMERGENCY CONTACT (Mandatory)
Emergency Contact Full Name
*
Emergency Contact Phone
*
Relationship (ex: Mother, Father, etc.)
ACCOMMODATIONS
Room Type
*
Select One
Junior Suite GARDENVIEW (SINGLE) $1,985 per person
Junior Suite GARDENVIEW (DOUBLE) $1,525 per person
Junior Suite GARDENVIEW (TRIPLE) $1,445 per person
Junior Suite GARDENVIEW (QUAD) $1,425 per person
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Junior Suite OCEANVIEW (SINGLE) $2,065 per person
Junior Suite OCEANVIEW (DOUBLE) $1,575 per person
Junior Suite OCEANVIEW (TRIPLE) $1,495 per person
Junior Suite OCEANVIEW (QUAD) $1,475 per person
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Junior Suite GARDENVIEW Butler (SINGLE) $2,290 per person
Junior Suite GARDENVIEW Butler (DOUBLE) $1,725 per person
Junior Suite GARDENVIEW Butler (TRIPLE) $1,625 per person
Junior Suite GARDENVIEW Butler (QUAD) $1,589 per person
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Junior Suite OCEANVIEW Butler (SINGLE) $2,345 per person
Junior Suite OCEANVIEW Butler (DOUBLE) $1,765 per person
Junior Suite OCEANVIEW Butler (TRIPLE) $1,675 per person
Junior Suite OCEANVIEW Butler (QUAD) $1,640 per person
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One Bedroom GARDENVIEW Butler (SINGLE) $3775 per person
One Bedroom GARDENVIEW Butler (DOUBLE) $2198 per person
One Bedroom GARDENVIEW Butler (TRIPLE) $2075 per person
Are you interested in trip protection/insurance?
(If yes, you will be contacted with pricing)
Yes
No
Roommate #1 Full Name
Roommate #2 Full Name
Roommate #3 Full Name
MISCELLANEOUS
T-shirt Size
*
SM
M
L
XL
2XL
3XL
4XL
First time traveling with us?
*
Yes
No
Comments/Special Instructions
Affiliate/Promoter Registered With?
*
Select One
BedroomEyes Ent.: Sheila
BedroomEyes Ent.: Suave
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Next Stop Promotions: Swagga
Next Stop Promotions: Chad
Next Stop Promotions: Bea
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Travel In A Dash: Dash
I hereby authorize Beauty and the Beach to accept my registration for the 2024 Beauty and the Beach Ultimate Winter Escape—Costa Rica.
Electronic Signature
*
Date (mm/dd/yyyy)
*
Security Code
*