Mars Application

Name:____________________________________ Birth date:________________

(last) (first) (MI)

Family Members (if traveling with):

Name (last, first)
1. _________________________________________
2. _________________________________________
3. _________________________________________
4. _________________________________________
5. _________________________________________
6. _________________________________________
*if more space is required attach another sheet with you name and family members name

Personal Items:
Item and description Weight (lbs)
1. __________________________________________________
_________________
2. __________________________________________________
_________________

Health: (dietary needs, allergies, vaccinations, etc.)

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Payment Option:
Pay total now
Pay in increments
Daily
Weekly
Monthly
*if you choose to pay in increments a email or letter will be sent to you tell you the price you must
pay each day/week/month Please circle: email or mail

Additional Information: (please include any additional information you wish to tell us)
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