Louisiana reg

Registration for St Therese Louisiana Tour
November 13-18, 2016

Please submit a separate registration for each traveler

After you complete and submit this form, you will automatically be re-directed to the Payment Page, to pay by credit or debit card. A deposit of $265 is required to reserve your space on this tour.

    NOTE: The name you enter below must be exactly as it appears or will appear on your official government photo ID.

    First Name (required)

    Middle Name (if applicable)

    Last Name (required)

    Date of Birth (required)

    Country of Birth (required)

    Mailing Address (required)

    City (required)

    State/Province (required)

    ZIP/Postal Code (required)

    Telephone (required)

    Your Email (required)

    I am: FemaleMale

    I am requesting: Single AccommodationsDouble Accommodations

    I have physical limitations that require special attention. I am entering details in the "Optional Message" area below.(Most situations can be accommodated, but we must know beforehand in order to make arrangements, and there may be additional costs.)

    I require a special diet and am entering details in the "Optional Message" area below

    I do not have a roommate and I understand RMC Travel will try to match me with a suitable roommate(s).

    (Optional) My roommate(s) will be:

    Optional Message

    I understand that RMC highly recommends the purchase of Trip Cancellation Insurance, and our preferred Insurance provider is Allianz.

    (required) I understand and accept the Terms and Conditions for this program.
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    After clicking, you will automatically be re-directed for secure online payment.

    If you have already registered and would like to go to directly the Payment page, please CLICK HERE