Cruise Registration Form

1
Full Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.
Area Code
Phone Number
3
E-mail* This field is required.
4
Date of Birth* This field is required.
Month
Day
Year
5
Approximately Date of travel* This field is required.
Date
Month
Day
Year
6
No. Of Adults* This field is required.
7
No. Of Children* This field is required.
8
No. Of Cabinets* This field is required.
9
No. Of Days* This field is required.
10
Do you have a passport* This field is required.
YESNO
11
Cruise Line* This field is required.
Carvinal
MSC
Royal Carribean
Voyage
Other
12
Destination* This field is required.
13
What port do you want to leave from* This field is required.
14
Another port Option* This field is required.
15
What type of cabinet
Please Select
Please Select
Interior
Ocean view
Balcony
Suite
16
Additional Requests
17
Do you want travel insurance?* This field is required.Nikiwe Travels highly recommands travel insurance.
YESNO
18
What type of vibe are you looking for
19
Did you cruise on this ship before?
YESNO
20
If yes, please provide your #.for more discounts
21
On board language* This field is required.
22
Dinner perferences
Please Select
Please Select
early
late
23
My Products* This field is required.Research Fee
prevnext( X )
My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
3 months or more travelex. if you travel date is 90 days prior to submitting
$20.00Edit
Back
3 months or lessex. if traveling date is less than 90 days
$25.00Edit
Back
Total cost $0.00
24
Payment Methods
Please click one of the PayPal options to complete payment and submit the form.
Should be Empty: