Phone: (417) 451-5468 | Email:

KSN / Jim Jackson Group

Oktoberfest & Central Europe 2018

September 15 – 26, 2018

 TRIP RESERVATION FORM

 Legal Name/s (as appears on passport)             Gender             Date of Birth          Daytime Phone

 1.____________________________________      ________          _____________     ___­­­_______________

 2.____________________________________      ________          _____________     __________________

 Mailing Address__________________________________________________________________________

 Home Phone ___________________ Work Phone ___________________ Cell Phone ___________________

 Email___________________________________________________          

 Will you be sharing a room with someone not listed above?  If yes, please give us their name:

 _____________________________________________________________________

 Do you wish to pre-pay your tour gratuities with your final payment:            Yes                  No

 Trip Deposit Enclosed ($600 per person)       ___________________

 Travel Insurance ($269 per person)               ___________________

                         Total Payment Enclosed        ___________________

  

Make checks payable to GalaxSea Cruises & Tours

 OR we can charge your credit card with the payment listed above:

 Credit Card Number ______________________________________Sec Code ________Expiration ____________­____

 Name on Card___________________________________ Signature__________________________________________

 Credit Card Billing Address__________________________________________________________________________

 Special Needs or Requests

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

COMPLETE AND MAIL WITH DEPOSIT TO:

GalaxSea Cruises & Tours, 210 N. Business 49, Neosho, MO  64850

Or Fax to 417-451-9120, email contact Ken Mayer – ken@galaxseaonline.com