A LITTLE MORE ABOUT YOU!

Thank you for your interest in booking an amazing vacation with us. Please take a moment to complete the following Client information form.

Customer Form

To be completed for each traveler/passenger, you will need passport and credit card information. (Main traveler is the person whose credit card will be charged for this vacation). ( * denotes mandatory field)
I am the main traveler/Credit Card Holder.*
Yes
No
Relationship to Traveler*
Last Name of Primary Traveler*

TRAVELER INFORMATION AS IT APPEARS ON PASSPORT
Last Name*
First Name*
Middle Name
Birth Date*
Gender*
Citizenship*
Please specify for OTHER

Passport Details (passport must be valid a minimum of 6 months from date of return)
Passport Number*
Expiration Date (mm dd yyyy)*

Issue Date (mm dd yyyy)*

Issuing Country*
Please specify*

CONTACT INFORMATION
Street Address*
Address 2
Apt/Suite
City*
Province / State*
Postal / Zip Code*
Country*
Primary Phone*
Secondary Phone
Other Phone
Primary Email*

Alternate Email

EMERGENCY CONTACT INFORMATION
Emergency Contact Full Name*
Emergency Contact Phone*
Emergency Email*

Relationship to Traveler*

CREDIT CARD INFORMATION
Please be advised that credit cards are not processed in real time. In some cases, it may take up to 72 hours for charges to appear on your credit card. Once processed, an invoice/receipt will be issued to the main traveller at the email address provided.
Card Number*
Expiration*

Name on Card*
Credit Card Type*
CVV*

ADDITIONAL INFORMATION
Do you have allergies or dietary restrictions?*
Yes
No
Please Specify
Do you have special needs or medical conditions that we should be aware of?*
Yes
No
Please Specify
Do you already have a travel date?*
Yes
No
Start Date

End Date