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Make check payable to: New England Bob's Mail to: New England Bob's Quebec Adventures 71 Pleasant Street Plainfield, MA 01070 TRIP REGISTRATION FORM Name: ____________________________________________________________________________ Address: ________________________________________________________________________ Telephone: ______________________________ Fax: _________________________ Work Phone: _____________________________ EMAIL: ______________________ Sled Information: Year: ______________ Make: __________________ Model: ___________________ Odometer: _________________ VIN# _________________________ CC __________ Current registration: # _________________ State __________ Exp. Date: _________ (Please include a copy of Registration for issue of Trail Permit for Québec Trails. Trail pass purchase price subject to current exchange rate. (Trail pass includes $500,000 accident liability insurance) Room Partner Request: ___________________________________________________________ Trip Name: _______________________________________________________________________ Trip Dates _______________________________________________________________________ List Medical or Other Considerations: ____________________________________________ Single occupancy add $35 per night: Number of nights ______ Amount: ________ $160 US per day sled rentals no discounts ___ (Check) if you need rental sled. (includes insurance and clothing, oil, unlimited miles, facemask, helmet, registration) Deposit required. PAYMENT METHOD _____ Check enclosed amount $ _______________ _____ VISA _____ American Express _____ MasterCard _____ Other _____ Card Number:________________________________ Exp. Date: __________ Dealer stamp - Travel agency stamp