Custom Package – Laurie Ayala- Nosara Beach Hostel-Open Dates Copy

Flexible Dates

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1 Choose the dates of your stay

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Minimum stay is 7 nights

2 Price

$1,890.00 – Program Price

* Transportation to / from Liberia (LIR)
* 7 nights lodging at Nosara Beach Hostel - shared room
* (10) --4 group and 6 private with Dani (3 of these privates have been pre-paid and are not charged again)
* Breakfast daily
* Dinners nightly with Safari (except on Sunday)
* Daily yoga
* Surf photos
$2,400 USD/single occupancy (prior quote) $2,400 - $260 for prepaid lessons $2,140 -$250 special discount if booked by end of May $1,890 USD single occupancy

3 People in your group

Guest 1		First Name* Last Name* Email*
Guest 1		First Name* Last Name* Email*

4 Participant Info

	Send me a reminder if I don't register today
First Name *
Last Name *
Email *
Phone *
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Email newsletter *	Please send me the email newsletter
Comments or Special Needs
Diet Notes
Emergency Contact Info *
Medical Issues	Enter "none" if you have no issues
Country
Profession
Arrival Itinerary	Include Airport, Airline and flight number, time of arrival
Departure Itinerary	Enter airport, Airline and flight number, departure time
Notes
What is your surfing level? *
Terms and Conditions *	I agreeUnderstanding the risks of travel, surfing and all outdoor activities, I, on behalf of my family and personal representatives, agree to assume all risks and responsibilities surrounding in my participation of surf lessons and travel to Costa Rica. I release, forever discharge and waive my right to sue Safari Surf School from and against any and all liability for any harm, injury, damage, claims, demands, actions, causes of actions, costs, and expenses which may arise by my travel. I further agree that this release shall be governed and interpreted in accordance with the law of the State of California, USA.
Photo Release	Check if you do not wish to release your rights to photographs

5 Donate

Please enter your donation amounts below

$	Nosara Wildlife Refuge Our Emergency Response Team responds to more than 200 wildlife emergencies each year and is specifically trained to deal with monkeys and other wildlife who are injured by falling from broken branches, high-voltage electrocutions, cars and attacks from other wildlife or domestic pets. The Refuge receives and treats all types of wild animals, but howler monkeys have become our specialty. Because of our expertise and experience with rehabilitating howler monkeys, we also receive monkeys that have been injured in other locations from all over Costa Rica. We rescue, rehabilitate and release. http://refugeforwildlife.com/ Donate to their site directly and receive a tax deductible receipt!
$	Pack for a Purpose We are proud to work with Pack for a Purpose and are happy to donate any items that you bring with you to share with the local community. We seek out families in great need and make sure that your contribution is donated with care. Examples of needed items include: clothes, toys, art supplies, school supplies, Spanish language books, & personal care items. If you can bring any of these items with you to donate, it will be much appreciated! If you would like to donate a monetary amount, we will purchase needed items and bring them to the local famillies.

Nosara Wildlife Refuge

Our Emergency Response Team responds to more than 200 wildlife emergencies each year and is specifically trained to deal with monkeys and other wildlife who are injured by falling from broken branches, high-voltage electrocutions, cars and attacks from other wildlife or domestic pets. The Refuge receives and treats all types of wild animals, but howler monkeys have become our specialty. Because of our expertise and experience with rehabilitating howler monkeys, we also receive monkeys that have been injured in other locations from all over Costa Rica. We rescue, rehabilitate and release. http://refugeforwildlife.com/ Donate to their site directly and receive a tax deductible receipt!

Pack for a Purpose

We are proud to work with Pack for a Purpose and are happy to donate any items that you bring with you to share with the local community. We seek out families in great need and make sure that your contribution is donated with care. Examples of needed items include: clothes, toys, art supplies, school supplies, Spanish language books, & personal care items. If you can bring any of these items with you to donate, it will be much appreciated! If you would like to donate a monetary amount, we will purchase needed items and bring them to the local famillies.

6 Payment

* Please provide the CV code on the back of your card (3 digits) or the front for Amex (4 digits)

* Please make sure the address you input is the same address your bank or card company has on file, or your transaction may be declined

Sub Total	$0

Taxes	$0

50% Deposit	$0

Due Now	$0 $0

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Last Name
Address *
City *
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Postal/Zip Code *
Country *
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Card Number *
Card Expiration *	Month Year
Card Security Code	usually a 3 digit code on back of card