Lion and the Lamb Journeys
Reservation Form

ONE FORM IS REQUIRED FOR EACH ROOM & MUST BE MAILED IN WITH DEPOSIT
Please write names as they appear on your Government issued photo ID

Name and Date of the Event:  _______________________________________________ 

Name: _________________________________________________________________ 

Address: ________________________________________________________________ 

City, State, Zip: __________________________________________________________ 

Home Phone: _____________________________ Work Phone: ____________________

Email Address: ___________________________________________________________

Would you like a single room supplement?    YES     NO

Do you need a roommate?  YES    NO  (If no roommate is available, you will be charged the single supplement)

If applicable, please list roommate's information:

_________________________________________________________________________
Name                                                                    Address                                                              Phone number/Email address 

Would you like a Smoking Room?    YES        NO

We recommend optional travel insurance.   Would you like us to send you an Insurance Brochure?    YES    NO

 To pay deposit by credit card, please fill out information below.  We will send you a receipt when processed.

Check type of card:    _____Visa            _____Mastercard            _____AMEX            _____Discover

Name on card ____________________________________________________________________
Card Number _________________________________________Expiration Date _______________

Please mail this form with deposit to guarantee space (check payable to Lion and the Lamb Journeys) to:
Lion and the Lamb Journeys
1089 Sagamore Pkwy West
West Lafayette, Indiana  47906