Personal
Information
**IMPORTANT** The
First and Last Name that you type below, Must Match your
VALID PASSPORT which is required to board the ship |
|
| 1st Passenger |
|
| First Name |
|
| Last Name |
|
| Date of Birth |
|
| Identification |
|
| 2nd Passenger |
|
| First Name |
|
| Last Name |
|
| Date of Birth |
|
| Identification |
|
| Address |
|
| City |
|
| State |
|
| ZIP Code |
|
| Country |
|
| Phone (Day) |
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| Phone (Evening) |
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| Email Address |
|
Cruise Preferences |
|
| Room
Preference |
|
| Dining Table |
|
| Most of the group will be
having dinner at the second seating which is around 8PM. If you
prefer to dine at 6PM, Check Here |
| |
|
Special Requests, dietary or
medical requirements: Type in category and stateroom rate
you wish to request. If you would you like to share a cabin,
and would like us to share your name and e-mail with others
that wish to share accommodates, please write it in the box
below. |
|
Names of friends you wish to
dine with:
|
|
|
| If you
would like to purchase air
arrangements and transfers between the airport and ship (from
the cruise line) please enter
you departure city. We will request your air and e-mail you with a
price quote: |
Cabin Category & Pricing
3rd or 4th guest sharing a room $589.00 each |
|
Twin Share
Rates*
(Prices are Per Person) |
|
| Single Rates* |
|
Please
see Rates & Pricing for Details
In addition to above cruise only rates, Port tax of $170.00 and gov't tax of
54.21 will be added per guest.
*Port tax , government tax, and fuel
surcharges are subject to increase. |
Travel Insurance |
|
Travel Guard
Insurance - Up to Age 59. Covers 100% for covered reasons
(Plus $9 Policy Fee) |
|
|
Please see
Terms
& Conditions for more information
|
Payment Information |
|
| A
$350 deposit is required for each passenger, you may provide your
credit card number now or by phone later by selecting 'Pay by Phone'
below (an operator will contact you for your details). Final
Payment is due by October 30, 09 |
| Payment
Method |
|
| Credit Card
or Phone Number |
|
| Cardholder |
|
| Expiration
Date |
|
| Tick
here to use the same card for your final payment |
| Are
you interested in charging monthly installment Payments? If so
how much per month? $ |
Optional Information |
|
| How did you
hear about this cruise? |
|
