RESERVATION FORM

Name______

Street Address ______

City ______State ______Zip ______

Reservation Dates ______

E-mail ______

PAYMENTS 25% of total due is needed to reserve your trip. Balance is due 45 days prior to arrival date in Costa Rica.

Total Payment (if paying by Paypal, please add 3% to your total) ______

Payment Method: Checks should be made out to “Sports For Nature,” and mailed along with this registration form to: 2693 Vassar Place Columbus, OH 43221

Online payments can be made online via: Zelle: Stephanie.morera@.com : Stephanie-Morera, [email protected] Pay: Send us your Gmail address, and we’ll send a payment request link! Paypal: https://www.paypal.me/PuraVidaHouse (please add 3%)

RELEASE In consideration of making facilities and/or services available, I do hereby and for and on behalf of myself, my family members or other travelling partners on this trip who have not signed a similar form, and my heirs and legal representatives, release and forever discharge Sports for Nature, Pura Vida House and its owners, managers and representatives from any and all claims and demands of every kind, nature and character which I may have or hereafter acquire for any and all damages or losses which may be suffered or sustained by me in connection with our activity and all such claims are hereby waived and released.

Signature ______Date ______

We want to hear from you! Mail form and make payments to: PuraVidaHouse.com Sports For Nature (614) 600-1904 - office 2693 Vassar Place [email protected] Columbus, OH 43221 Or scan and email form to: [email protected]