Travel Booking Form for Bali 2025 Queens Travel Group

Travel Booking Form for Bali 2025 Queens Travel Group
Full Name (As Per Passport)

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth *
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name First Name* Last Name*
Emergency Contact Phone Number Area Code* Phone Number*
Select Villa Option
**Roommate Information** (if applicable):
   - Name of Roommate
   - Roommate’s Contact Information
   First Name   Last Name   Area Code   Phone Number
Will you need assistance booking flights?
If yes, please provide the following. *Departure City *Preferred Departure Date *Return Date
Include Any Medical Accommodations Needed
*Itenerary Included In Total Amount*

Arrival *Meet and Greet* (July 10,2025)

Tegalalang Rice Terrace & Monkey Forest (July 11, 2025)

ATV Adventure & Group Dinner (July 12, 2025)

Gates of Heaven Tour (July 13, 2025)

Cretya Day Party & Waterfall Tour (July 14, 2025)

Free Day (July 15,2025)

Pool Party *Color Themed* (July 16, 2025)

Spa Day (July 17, 2025)

Depart (July 18,2025)
Payment Plan Selection
*Terms and Conditions*

**Cancellation Policy**

   - I have read and understand the cancellation policy for this trip.

   - Acknowledge that the deposit is non-refundable after October 27, 2024.

   - Agree to make payments on time and understand that missing payments may result in cancellation of booking.
Room Selections:
prevnext( X )
Single Pool View
$2,991.50 Quantity



Single Garden View
$2,791.40 Quantity



Double Pool View
$4,096.00 Quantity



Double Garden View
$3,701.00 Quantity



Deposit
$500.00 Quantity



Total

$0.00
Signature
Website: https://queenstravelgroup.com

Email: info@queenstravelgroup.com

Phone: 714-684-6427
Should be Empty:

Travel Booking Form for Bali 2025 Queens Travel Group

Room Selections:*

Room Selections: