FIESTA TRAVEL DESIGNS – PIGEON FORGE & SMOKY MOUNTAINS SHOW TRIP
September 3 – 8, 2018

Cost $569 (Double Occupancy)……Deposit of $150 due at signing
(Single Occupancy Cost - $739…………Triple Occupancy Cost - $549)
Balance Due: 6/26/18………...…NOTE: Each person in room must fill out this form.

Contact Person: Diane Gaines, 318-348-1034      (Please Print Info Below)

Name___________________________________________ Date of Birth________________

Your Roommate (s) ___________________________________________________________

Address______________________________ City_________________ St_____ Zip_______

Home Phone____________________________Cell_________________________________

Make TRIP DEPOSIT CHECKS payable to: Fiesta Travel Designs
Mail this form + deposit check to: Diane Gaines, 705 Wheelis Street, West Monroe, LA  71292

Need trip insurance?   YES____ NO____   
Cost is  $45  (for Double or Triple occupancy)                (Single occupancy=$69)
   For Insurance: Enclose a SEPARATE CHECK payable to: “Travel Insured International”

Today’s Date______________ Deposit Paid__________ Check # _________ Balance_____________
PRINT THIS PAGE TO REGISTER FOR PIGEON FORGE & SMOKY MOUNTAINS SHOW TRIP
Note: Registration due by April 27, 2018. Seating is limited to the first 50 individuals.