Kindly complete this form to allow me to book or register you for your upcoming vacation. Be sure to enter your legal name and date of birth exactly as they appear on your passport.
(A separate form is required for each person traveling with you.)
BOOKING / CONFIRMATION # OR NAME OF GROUP
Name
First Name
Middle Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
You have verified that your name and date of birth is identical to what is on your passport.
Yes
No
Phone Number
E-mail
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Passport Number
Passport Issue Date
-
Month
-
Day
Year
Date
Passport Expiry Date
-
Month
-
Day
Year
Date
Nationality / Citizenship
Known Traveler Number
Redress Number
Emergency Contact Name / Relationship
Emergency Contact Phone Number
Do you want Travel Protection Insurance?
*
Yes
No
It is strongly recommended to purchase travel insurance, If you choose not to purchase travel or cancellation insurance, you understand that you are liable for any cancellation fees and/or any out of pocket expenses incurred. You will also make your own provisions in the event of an emergency while traveling. I understand the Trip Insurance premium is non-refundable.
My agent offers retail service to customer, which are provided by separate and independent vendors of travel services. They do not operate, control, or otherwise provide the services of the independent travel vendors. I agree and understand that my agent is not responsible for any operating failures, loss, damage, delay, or injury to me or members of my traveling party, nor for consequential damages, which may result from failure, delays, or injuries which arise out of or during the scheduled travel. I agree and understand that my agent is not responsible for any damages, direct or consequential, which may arise as a result of acts of God, social or labor unrest, war, political or national strike, terrorist activities, mechanical failures, climatic conditions, or any other actions or commissions beyond the control of Shelly English / VACATIONS by Shelly LLC.
All photos captured by VACATIONS by Shelly LLC are the exclusive property of the company and may be utilized for advertising purposes.
I acknowledge that I have read this registration form completely and the information I provided is accurate. I understand that my deposit is non-refundable and other cancellation penalties will apply depending on the cancel date. I understand that if my roommate (s) cancel, my rate will change. I understand that all monies must be paid by the final payment date. If my balance is left unpaid, my cabin and/or room will be canceled immediately. Prices for reinstated cabins and / or rooms maybe higher than initial rate and a $50 reinstatement / administration fee will be charge by VACATIONS by Shelly LLC regardless of the cancellation date.
I have been informed of the cancellation policies for our travel services and have been made aware of the benefits of travel protection.
Yes
Your signature is required to complete your travel plans.
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