Dine-Around Program Online Order Form
Number of Dine-Around Programs Required
Adults
Children
3 dinners, US $117.00 per person
5 dinners, US $190.00 per person
7 dinners, US $262.50 per person
5 Breakfast or Lunches PLUS 4 dinners,
US $230.00 per person
VIP Gift certificates - Purchase a US $50.00 gift certificate for US $45.00 per person/per dinner
NOTE: Children 4 - 12 years of age pay one half price
Contact Information
First Name:
Last Name:
Email:
Arrival Date:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Date
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2006
2007
2008
2009
2010
2011
2012
Hotel / Resort:
Billing Information
Credit Card Type:
Select a Card
American Express
Mastercard
Visa
Full Name:
Credit Card Number:
Expiry Date:
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2006
2007
2008
2009
2010
2011
2012
Comments: