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Application for Reserved Space

Please complete and print this application then mail or FAX it to:

TLC Worldwide, Inc.

P.O. Box 924994

Houston, TX 77292-4994

Phone (713) 896-9993 or FAX (713) 681-0950

I have read and understand the following:

T.L.C. Worldwide, Inc., its employees, and officers are responsible only for offering the services described, and will not be held responsible for accidents, injuries, illnesses, or legal consequences (arising from the indiscretion on the part of the participants or external factors). T.L.C. Worldwide, Inc. reserves the right to terminate members from the tour at any time due to improper conduct. I also affirm that I am not presently married. I hereby give permission to T.L.C. Worldwide, Inc. to use (and release) possible appearances of me in any upcoming promotional materials.

Signature: _______________________________________________________________

Name:
Street Address: Apt or Suite #:
City: State: Zip:
Phone(Home): Phone(Work):
Phone(Mobile): F A X:
Today's Date:

Please check one of the following:
Enclosed is myMoney Order CheckVISA/MC "Convenience Check"
for $250 nonrefundable deposit for my

VISA/MC "Convenience Checks" - Call the (800) number Customer Service Department on the back of your credit card to order checks.
Make check or money order payable to "T.L.C. Worldwide, Inc."
More complete, detailed instructions and advice will be mailed to members holding reservations at least 2 weeks in advance of our departure date.

We want you to have the most enjoyable trip possible and assist you in every possible way. We anticipate a scenic, fun and productive trip for all !

RESERVATION TERMS