Phone: (417) 451-5468 | Email:

2018 Alaska Cruise Package

August 9 - August 17, 2018

RESERVATION FORM

 

Passenger Name(s)                                                     Date of Birth    Gender                        Daytime Telephone

(Name spelling should match your passport/driver’s license)

 1._______________________________________   ___________  _______          _________________

 2._______________________________________   ___________  _______          _________________

 Mailing Address: _____________________________________________________________________________________

 Home Phone: _________________Work Phone: _________________ Cell Phone: __________________

 Email Address: _____________________________________ Home or Work

 Room Type Requested ___________________________________ (Inside, Ocean, or Balcony)

 Are you sharing your room with anyone not listed above?

 _____________________________________­­­­­­­­_________________

 Dinner Time (circle one):                     6:00pm                        8:30pm                        My Time Dining

 Travel Insurance (Yes or No)   ________________

 Amount Enclosed:        Cruise Deposit ($400 per person)       ________________

                                                                          Insurance        ________________

                                                                  Total Enclosed        ________________

 Please make checks payable to GalaxSea Cruises & Tours.

 CHARGE TO YOUR CREDIT CARD:

 Credit Card Number: ________________________________ Sec Code _________ Expiration ______________

 Name on Card: ________________________________     Signature: ____________________________________

 Credit Card Billing Address:

 __________________________________________________________________________________________

 SPECIAL NEEDS/REQUESTS

 __________________________________________________________________________________________

 __________________________________________________________________________________________

 __________________________________________________________________________________________

 COMPLETE AND MAIL WITH DEPOSIT TO:

GalaxSea Cruises & Tours, 210 N. Business 49

Neosho, MO 64850

Or Fax to 417-451-9120