Weight Loss Camp on the French Riviera - Registration form

By navigating in the tree on the right side, you will find in this blog:

• your objectives when following our Weight Loss program
• how our program will change your life
• what we propose you
• a few statistical facts
• a typical program planning (week-day & weekend)
• our rates
• list of activities (conferences, sightseeing, events...) 

Registration form
Please, cut and past this form, fill in one booking request per session and send it to rivieraapt@aol.com

Family name
Address
Telephone
Alternate email address

Session dates in 2011
                                      spring    22/4-12/5, 13/5-2/06, 3-23/06
                                      summer 8-28/7, 29/7-18/8, 19/8-08/9, 09-29/09, 30/09-20/10
         1st choice:
         2nd choice (if applicable):
         3rd choice(if applicable):

Total number of people (preferably with age)
         Adults (18 or over)
         Kids    (under 18)

First name, age, size and weight of people intending to follow the weight loss program

Number of rooms
         Standard Bedrooms with shared bathrooms
                             Double occupancy   2280€ x         =
                             Single occupancy    3420€ x         =

         Executive Bedrooms with private bathroom and WC
                             Double occupancy   2580€ x         =                 with a king size bed
                                                                                                                                       or two large single beds
                             Single occupancy    3870€ x         =