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Travel Adventures : Fun, informative, sStress-free travel

DAY TRIP REGISTRATION FORM

[ ] TRIP #1: Friday, November 21
8:30am-8pm
VAN GOGH AT NIGHT at MOMA and Joseph Cornell and More
at Hollis Taggart Gallery
$100 (members $90)

[ ] TRIP #2: Wednesday, December 10
THREE GIFTS IN NEW HAVEN
Tour of Yale Center for British Art, Lunch at Union
League Café, & a Play at Long Wharf Theatre
$135 (members $125)
includes lunch at the Union League Café

Note: seats are assigned in the order that paid reservations arrive.
Parties wanting seats together should register together. TOTAL: $______

REFUND POLICY: Cancellations prior to refund dates are subject to a $10 handling fee.
There are no refunds after the refund date cited for each trip.
There are no refunds on theater or ballet tickets.


NAME/S:_____________________________________________________________
ADDRESS: ___________________________________________________________
CITY/STATE/ZIP:_______________________________________________________
TELEPHONE:__________________________________________________________
E-MAIL:______________________________________________________________

Confirmed reservations require pre-payment. Make checks payable to “Florence Griswold Museum.” Mastercard, Visa, or American Express also accepted. $10 processing fee for
cancellations made prior to refund dates noted above. No refunds after the specified date.

[ ] VISA [ ] MASTERCARD [ ] AMEX (CHECK ONE)
CARD #:______________________________
EXPIRATION DATE:______________________

LIABILITY RELEASE: While exercising due care in the selection of services provided on this trip, the Florence Griswold Museum shall not be under any liability or responsibility whatsoever for the death or injury of any person or property, however occurring, on, during, or in relation to the trip.

SIGNATURE:_______________________________________DATE:_________________

Please complete REGISTRATION FORM and return with payment to:
Florence Griswold Museum, 96 Lyme Street, Old Lyme, CT 06371
attn: Matt Greene