CONSENT TO RECEIVE FAXES 

For Individuals

Due to new federal regulations, your ability to receive faxes from us will be severely restricted as of July 1, 2005. To comply with these restrictions and continue to be able to received faxed information from us, we need your signature on the form below, with all applicable spaces filled in, and returned by fax to the number at the bottom of the page..

I hereby grant consent to receive faxes from Berkeley’s Northside Travel, Inc and any of its

Subsidiaries and affiliates for all purposes directed to any of the following fax numbers, which I own or control:

___________________, ___________________, ___________________,

_______________________________

(Signature)

_______________________________

(Print Name)

______________________________

(Date)

Return by fax to: 510-843-7537

Thank you.

Note: Please print this form, then fill up the required information and fax the completed form back to us at 510-843-7537