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Catholic Shrine Pilgrimage

Golden Frontier
4100 North Illinois St
Swansea, IL 62226
PH: 618-234-1445
FAX: 618-234-9861
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Colorado Springs

Colorado Springs,Pikes Peak Region
May 11 to 19, 2015

$50.00 per person registration fee must accompany this application. Balance of fee is required 35 days prior to departure. Husband and wife may use the same application, enclosing double registration fee.

Clicking the submit button will transmit this application and charge authorization to GOLDEN FRONTIER, 4100 N. Illinois St., Swansea (Belleville), IL 62226. Please charge my deposit for this trip to my indicated credit card. Cancellations and requests for refunds must be submitted in writing to Golden Frontier and will be issued in agreement with the cancellation policies of the original trip brochure. I have read the trip brochure and understand the general information, terms and conditions including fees, responsibility, refunds and cancellations, optional trip cancellation and baggage insurance portions of the trip brochure. Confirmation will be sent upon receipt of deposit and application. My electronic application indicates my electronic signature which I authorize to be the same as my original handwritten signature and agreement to the terms and conditions of the trip brochure.

* Required Fields

COLORADO SPRINGS AND PIKES PEAK REGION
*2nd Passenger:
*1st Passenger:
3rd Passenger:
I have special dietary needs:
Triple occupancy discount requested.:
Separate application and appropriate deposit required.
*Mailing Address:
*City:
*State:
*Zipcode:
Home Phone:
Cell Phone (His):
Cell Phone (Hers):
My choice of departure location:
Add Pikes Peak option at $54.00 per person.:
Both options are simultaneous; it is not possible to take both.)
Add Manitou Cliff Dwellings option at $28.00 per person.:
Single accommodations requested at $280.00 extra.:
I am a single traveler, but will accept a same gender roommate.:
Both options are simultaneous; it is not possible to take both.
My roommate for this trip is:
I/We are traveling with friends::
Nick name to use on name tags::
Smoking Preference:
Disabilities limit my walking. Please request lodging staff to place my room near the coach loading area. I do not need a ground floor room if there is an elevator and my room is near it. Request a ground floor room if there is no elevator.:
I understand Golden Frontier has no control over room assignments assigned by lodging staff.
Amount you want charged on the card::
*CVV number on back of credit card ( for security the number is saved in a different location)::
Email Address:
* Payment Method:
Accountholder Information - must match billing information.
First Name:
Last Name:
Credit Card
Card Nbr:	**Numbers only
Exp Date:	/
CVV:	What is this?
Billing Address - must match billing information.
Street:
City:
State, Zip:
Country:
*Authentication:
*4 + 1 =	Enter the correct answer to the math question.
Please click the Send button only once.

GOLDEN FRONTIER

CATHOLIC SHRINE PILGRIMAGE

Colorado Springs