Cruise Information Booking Form
Prices, Terms & Conditions are Subject to Change.
PERSONAL INFORMATION:    
Name (as it appears on passport)   Date of Birth    
Name (as it appears on passport)   Date of Birth    
Child Name #1   Date of Birth    
Child Name #2   Date of Birth    
Child Name #3   Date of Birth    
Child Name #4   Date of Birth    
Address
City
State
Zip
Phone Number
E mail Address
Military Discount                ( With Proof of: Active Duty, Retired, or Reservist)
   

CRUISE INFORMATION:		  
Destination
Cruise Line
Number of Nights
Departure Date
Arrival Date
Purchase Travel Insurance  Must be purchased at time of reservation
Number of Cabins
Cabin "Type" Preference Interior     Ocean View    Balcony  Suite
Cabin Location Preference Forward    Aft    Amidships    No Preference
Bed Configuration Queen   (2) Twin   
Previously Sailed With This Brand:
Club / Privilege Card #
Dining Hour Preference Approx. 5:00pm    Approx. 8:00pm    Anytime Dining
Persons Per Table Preference 2    4    6    8     10
Over 55 Years of Age?
Special Needs, Celebrations

ADDITIONAL INFO:

  Air Included     Airport / Ship Port Transfers   

CAR RENTAL:
Pick-Up Time
Drop-Off Time
Pick-Up Location
Drop-Off Location
Vehicle Choice
Extras

PAYMENT INFORMATION:		 (Print & Fax if entering credit card information, or leave this section blank and call Leisure Travel with your card information 586-282-0973 - DO NOT EMAIL CC INFORMATION)
Credit Card Type Visa     MasterCard    American Express  Discover
Name on Credit Card
Credit Card #
Expiration Date
   
   

Request for additional information.

Other services you'd like us to offer: