West Park High School Band

West Park High School Band REGISTRATION FORM

Price Per Student $1075.00
Student Name:

First NameLast Name
Gender:
Students Email:
Student Date of Birth:

MonthDayYear
Date
Address of Student:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name:

First NameLast Name
Parent/Guardian Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Parents Email:

Acknowledgment of Terms and Conditions:
Does your student have disabilities or health conditions that may affect participation in the trip? If yes, please specify. (If not, place N/A in the box)
Signature

Credit Card Information

Should you choose the monthly payment option, your credit card on file will be charged each month. Should the card need to be changed, you will need to fill out another form by contacting our office at (916) 761-9591.

West Park Disneyland Trip 2027

West Park Band Deposit /Monthly Payment Option

After receiving your deposit, you will receive an email from accounts@crystalandcleartravel.com. Total cost of the trip: $1075.00 per student. All deposits and trip costs are non-refundable. Payments on the 10th of each month starting in September: $193.75. Payments are automatic with the same card used here.

$250.00 Quantity

West Park Band Pay in Full Option

This is a pay-in-full option. All payments are non-refundable.

$1,075.00 Quantity

Total

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please verify that you are human
I hereby authorize Crystal & Clear Travel to charge my credit/debit card for monthly payments or the pay-in-full option. If you choose the monthly option, the credit card used for the deposit is the card used for monthly payments. Should you decide to change the credit card a new authorization will be required.
Credit Card Signature:
Date:

MonthDayYear
Date
Should be Empty:

West Park High School Band REGISTRATION FORM

Credit Card Information

West Park Disneyland Trip 2027