Registration and Payment Authorization Form

Registration and Payment Authorization Form
Name as Appears on Passport (passenger 1)*

First NameMiddle NameLast Name
Birth Date (passenger 1)*

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Name as Appears on Passport (passenger 2)

First NameMiddle NameLast Name
Birth Date (passenger 2)

MonthDayYear
Date
Cabin Type*

Panorama Suite - $3,699 per person, double occupancy.
Pre Cruise Options

1 night stay in Amsterdam - cost TBDI am /we are interested in longer pre cruise options in Amsterdam.
Post Cruise Options

2 nights in Lucerne, Switzerland - $889 double occupancy or $1269 single occupancy.4 nights traveling to Lucerne, Switzerland and Lake Como, Italy - $1429 double occupancy or $2059 single occupancy.I am / we are interested in custom post cruise option.
Trip Extras

I am / we are interested in Group AirI am / we are interested in Travel Insurance
Deposit Payment*

Initial Deposit - $250pp due upon bookingSecond Deposit - $1,000 pp due July 31, 2024
Payment Method*

Personal Check, made payable to Travel Trends of HauppaugeVenmo (@traveltrends)Credit Card, we will call you for card details
Cardholders Name

First NameLast Name
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payment Authoriztion

I, the card holder listed above, hereby authorize Travel Trends of Hauppauge to charge my credit card for the deposit indicated above for each person traveling and confirm that the information for the credit card and billing address is complete and accurate.
1. All payments made by personal check must be made out to 'Travel Trends of Hauppauge'.

2. All final payment checks should be received no later than 15 days prior to March 31, 2025 to ensure your reservation.

3. Travel Trends of Hauppauge reserves the right to charge assessed bank fees for any returned checks.

4. For Venmo payments, please use @TravelTrends handle.
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