Cruise Booking Form 7 nights Western Caribbean Cruise

Please fill out one form per Cabin Ship Name ________________

Main Contact Information(Please Print Clearly)

 

Name:

 

 

Address

 

 

City

 

State

 

Zip:

 

 

Telephone

 

Email:

 

Passenger Information(Name as it appears on your passport) PLEASE PRINT CLEARLY

 

All Passengers must have a passport to travel on the cruise

Cancellation Insurance

 

Passenger Name(Print First, Middle, Last)

Birth date

Citizenship

Yes/No

 

Pricing per Person:

1

 

 

 

 

REQUEST

2

 

 

 

 

QUOTE

3

 

 

 

 

 

4

 

 

 

 

 

Special Requirements Any Birthdates, Anniversaries, Special Occasions, etc.

 

 

 

 

 

 

 

Cabin Booking

 

Cabin Category

(please circle):

I Inside O Ocean View B- Balcony S-Suites Upon Request

 

 

Traveling with:

 

 

Group Affiliation: Long term Financial Services Life Style Travel Club Online Advertisement

 

Final Payment is Due: Jan 15, 2017

Air Fare?

Yes No

City of Departure:

 

Interested in Pre or Post Cruise Package

Yes NO

Number of People:

 

Form Deposit

 

Form of Payment for Deposit

 

 

Deposit $ x Persons

$

 

Credit Card Accepted:

Harmony of the Sea Cancellation Insurance

$

 

American Express Master Card VISA - Discover

Total Enclosed/to Charge

$

 

I authorize Harmony of the Sea or Lifestyles Travel Club, LLC to Charge the above amount to the Credit Card listed below

 

Credit Card #

 

Expiration Date

 

 

Print Name

 

Date

 

 

Signature: