the Experts in Small Ship Cruising

Passenger Information Form

*Note - These fields are mandatory

Left Column

TRIP INFORMATION

Cruise Line

*

*

Booking Number

Trip Start Date
* * *
List any dietary and/or medical restrictions

Are you celebrating a special date
(Birthday, Anniversary...)

PASSENGER INFORMATION

Names must be as they appear on your passport.
Any changes made to the names will result in change fees.

Gender

*

Salutation
*
Last Name

*

Middle Name(s)

First Name

*

Date of Birth
* * *

I wish to receive further communication from Exclusive Tours

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Right Column

PASSPORT INFORMATION

Citizenship

*

Place of Birth

*

Passport Number

*

Place of Issue

*

Date of Issue
* * *
Date of Expiry
* * *

CONTACT INFORMATION

Street Address

*

Apartment or Suite Number

City

*

Province / State
*
Postal Code / Zip Code

*

Country

*

Phone Number (with area code)

*

Email

*

Terms & Conditions

It is the responsibility of the passenger named herein to obtain any required visa and documentation prior to departure, further that for the most part to have a valid passport for at least 6 months following the date of return from the trip. If required documents are not obtained passenger may be denied boarding at the airport and/or entry upon arrival. Regulations concerning visa requirements can change without notice at the discretion of the countries visited. Exclusive Tours accepts no responsibility for obtaining visas or for advising guests of visa or other immigration requirements. Passenger must also declare fitness to travel and to be self-sufficient. If travelling with a physical challenge guest must have an able-bodied travelling companion travelling with to take full responsibility of any assistance that may be required.

On behalf of the person named above, whose authority I have to accept these terms and conditions, I have read and accept the Terms and Conditions outlined on the guest confirmation or at www.exclusivetours.ca.

*

EMERGENCY CONTACT INFORMATION

Full Name

*

Phone Number (with area code)

*

Relationship to Traveler

*

TRAVEL INFORMATION

If you are booking cruise only, and are doing a pre-cruise on your own, please fill out below. This information is important in case there are any last minute changes.

Name of Hotel or Where Staying

City

Contact Number

ADDITIONAL TRAVEL INFORMATION

Additional information is required if you are purchasing your own air and are purchasing transfers from Exclusive Tours.

*

Departure Information

Departure Date
Departure City / Arrival City

Airline / Flight Number / Departure Time

Connecting Information

Departure City / Arrival City / Flight #'s

Departure City / FINAL Arrival City

Airline / Flight Number / Departure Time

Final Arrival Date / Time

Return Information

Departure Date
Departure City / Arrival City

Airline / Flight Number / Departure Time

Thank you for completing the passenger information form.

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