Intake Form

Intake Form
Client Information
Full Name:
Email Address:
Phone Number:
Address: (so laminated version can be sent to you)
Instagram handle:
Package Choice:
Trip Details
Destination:
Travel Dates- Going

MonthDayYear
Date
Travel Dates- Returning

MonthDayYear
Date
Purpose of Trip:
Travel Preferences
What type of traveler are you (check all that apply):

Other
Accommodations & Transportation

Only need to answer if booking the First Class Luxe Package
Accommodations (Select one):

Other
Transportation:

Other
Special Requests:
Any special requirements or accommodations needed (i.e. celebrations)
Travel Companions
Number of People Traveling:
Ages of children if traveling with any:
Additional Comments:
By submitting this form, I agree to the terms and conditions of Luxe Travels.

For First Class Luxe Package Only: when booking some excursions, some will require an card on file to book. I would need card information if necessary. TBD.
My Products
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Non-refundable Deposit
Deposit required and due upon submission of intake form.

$20.00 Quantity

Total

$0.00

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Client Information