Phone: (417) 451-5468 | Email:

San Antonio Reservation Form

San Antonio Tour

October 25th – 29th, 2018

 Reservation Form

 

 Passenger Names                         Date of Birth                Daytime Phone

1 ________________________ ____________________ _____________________

2 ________________________ ____________________ _____________________

  Address _________________________________________________________________________________

 Cell Phone_________________________________ Email____________________________________

Home Phone______________________________ Work Phone_________________________________

 Will you be rooming with anyone not listed above ___________________________________________

 Emergency Contact Person (not traveling with you) ___________________________________________

Emergency persons phone ________________________________________

Special Request/Dietary Needs

___________________________________________________________________________

___________________________________________________________________________

Deposit Amount ($200 per person)          ____________________

Insurance - $79 per person                      ____________________

$99 for single / $69 triple

Total Enclosed                                          ____________________

Make checks payable to GalaxSea Cruises & Tours.  Mail this form and your payment to GalaxSea Cruises & Tours, 210 N Business 49, Neosho, MO 64850

Call 417-451-5468 to join over the phone.