Costa Rica | February 17 - 24, 2024
Chosen Name *
Last Name *
Email Address *
Phone Number *
Home Address *
City *
State *
Zip Code *
Gender Identity (select all that apply) *
Female
Male
Non-binary
Transgender
Prefer not to say
Other
Pronouns
Full Name (as it appears on your passport)
Date of Birth *
MM
01
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DD
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YYYY
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2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
Legal Sex (as it appears on your passport) *
F
M
X
Dietary Restrictions (select all that apply) *
None
Vegan
Vegetarian
Dairy Free
Gluten Free
Kosher
Halal
Other
If other, please specify:
Please select your housing preference: *
Double-occupancy, random assignment
Double-occupancy, specified roommate
Single-occupancy, upgrade fee - $1,150.00
If you selected specified roommate above, please enter the full name of your preferred roommate:
Review Terms and Conditions
here
. *
I have read and agree to the Terms and Conditions as well as the Code of Conduct
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