NAME    COMPANION NAME 

ADDRESS        CITY   

PROVINCE/STATE       EMAIL ADDRESS

HOME TELEPHONE        BUS TELEPHONE

MAIN SITE WHERE YOU PLAY POKER ONLINE  24 Hour Poker Bugsys CD Poker Full Tilt Poker Pacific Poker Paradise Poker Party Poker Planet Poker Platinum Poker Poker Champs PokerStars True Poker The Gaming Club Other

PLAYER NAME AT MAIN SITE YOU PLAY POKER AT ?

HAVE YOU ATTENDED AN OUT-OF-COUNTRY POKER TOURNAMENT BEFORE ?  Yes No

WHICH POKER TOURNAMENT DO YOU WANT TO ATTEND ?

DATE YOU WISH TO DEPART   DATE YOU WISH TO RETURN

WHICH CITY WILL YOU BE FLYING FROM ?

DO YOU NEED US TO FIND YOU A TRAVEL COMPANION TO SHARE A ROOM WITH ? Yes No

NUMBER OF PEOPLE TRAVELING   OCCUPANCY OF HOTEL ROOM  Single Double Triple Quad

CHECK WHICH OF THE FOLLOWING YOU REQUIRE RATES ON:

AIRFARE     HOTEL WITH NO MEALS    HOTEL WITH MEALS    PRE AND POST TOURS

CATEGORY OF AIR REQUIRED Economy Class First Class Business Class   HOTEL CATEGORY   Budget Intermediate Superior Deluxe

WOULD YOU LIKE ADDITIONAL SIGHTSEEING INFORMATION FOR SPOUSE/MATE ?  No Yes

IF YOU ARE INQUIRING ABOUT A CRUISE TOURNAMENT PLEASE ADVISE CABIN CHOICE Inside Outside Balcony Suite

ADDITIONAL INFORMATION / SPECIAL REQUESTS