Hugh Parkey's Belize Adventure Lodge PO Box 1818 Belize City Belize Central America Tel: 501-223-4526 or 223-5086 Fax: 501-223-7874 E-mail: info@belizeadventurelodge.com

* Name: * Email: Phone: Fax: Street Address: City: State/Province: Postal Code: Country: *How did you find us? ------------ Belize by Naturalight Website Cruiseline - State which Sportdiver magazine Scubadiving magazine Dive Training magazine Destination Belize magazine Other magazine Local Dive Shop - State which Referral Banner Search Engine Adventure Travel Expo - NY Adventure Travel Expo - Chicago Adventure Travel Expo - Long Beach Adventure Travel Expo - Washington DC London Dive Show Beneath the Sea Dive Show Trex Trade Show Other Name of Cruiseline, Dive Shop or Other: I am interested in: Accommodations Kayaking Snorkeling Diving Educational Facilities Group Travel Inland Adventures Cruise Shore Excursion I plan to be there from: to Number of People in my party: adults children Ages of Children: *Comments/Questions: