Mystic Whaler Cruises 2004

Name ___________________________________________

Address___________________________________________

City _________________________, State ____      Zip _________

Day Tel ______________________  E-mail ____________________________

Fax _____________________________________
[    ]  Leg I - October 17-23, 2004  All prices are double occupancy
[   ] Great Room $660 [   ] Sloop Cabin $660
[   ]  Schooner Cabin $720 [   ] Brigantine $810
[   ]  Clipper $900
[    ]  Leg II - October 24-28, 2004  All prices are double occupancy
[   ]  Great Room $560 [   ]  Sloop Cabin $560
[   ]  Schooner Cabin $600 [   ]  Brigantine $680
[   ]  Clipper $720

Non-members, please add $45 to above prices.  To reserve your berth, send $100 deposit; 
$200 for both trips.  Full payment due on September 15, 2004.  No refunds after 9/16/04.  Cancellations prior to 9/15/04 receive full refund less a $50 handling fee.

[   ]  Check payable to NWSA enclosed for $______________
[   ]  Visa   or [   ]  Mastercard
Account No. ___________________________________________________
Exp. Date __________________
Signature on card ________________________________________________

To reserve your spot,  fax this form to NWSA at 781-631-2889 or call 401-682-2064 or
Mail this form to 
National Women's Sailing Association
70A Pleasant St., 
Marblehead, MA 01945