Reliant Cruising Website Interest Form

1
How would you describe your current status?* This field is required.We are all about meeting you where you are at! Simply let us know what point you are at and we'll go from there!
I'm ready to book and know exactly what I want.
I want a complimentary hold as I make my final choice, but I know what I want to hold.
I have a rough idea of what I want to book, but want some advice first.
I am looking over dates and itineraries at the moment.
I'm completely lost - help me!!
2
Is this your first time on a Regent Seven Seas Cruise?* This field is required.
Yes, it's my first Regent experience!
I have previously experienced RSSC!
3
Is there any particular offer/promo you were hoping to take advantage of?This part is mostly for those who saw some specific offer they want to use. Feel free to skip this section if non-applicable.
4
What is your name?* This field is required.
First Name
Last Name
5
If you prefer to be called by a different name, please us know here.
6
What is your best email? * This field is required.Don't worry - your data is extremely important to us. We do NOT share your email with any 3rd parties and you may opt out of hearing from us at any time.
example@example.com
7
Phone Number* This field is required.Don't worry - your data is extremely important to us. We do NOT share your phone number with any 3rd parties and you may opt out of hearing from us at any time.
Please enter a valid phone number.
8
What is the ship, name, dates of the itinerary you want to book?* This field is required.
9
Which suite you would like to book?* This field is required.
10
Would you like to go ahead and provide your basic details now to expedite your hold / booking?
Yes please!
No, not right now.
11
Please provide the primary guest's legal name as shown on the valid passport. * This field is required.Reminder: Passports must be valid for 6+ months AFTER the return of a trip, per common travel law.
First Name
Last Name
12
Please provide the primary guest's date of birth as shown on the valid passport.* This field is required.
Date
Year
Month
Day
13
Please provide the secondary guest's legal name as shown on the valid passport.* This field is required.Reminder: Passports must be valid for 6+ months AFTER the return of a trip, per common travel law.
First Name
Last Name
14
Please provide the secondary guest's date of birth as shown on the valid passport.* This field is required.
Date
Year
Month
Day
15
How many total guests are accompanying you on this itinerary?
Please Select
Please Select
1 person
2 people
3 people
4 people
5 people
6 people
A group of 7+
16
Please provide any other relevant names/DOBs. Please also any secondary or additional suites for your family or group.* This field is required.If you still need to collect some names/DOBs, you may note this below.
Huge
Large
Normal
Small
Ok
Ok
17
Please provide your primary mailing address:* This field is required.This information is kept secure and not shared with any other 3rd party outside of ourselves and Regent Seven Seas Cruises.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
18
Which ship(s) are you interested in?* This field is required.
Seven Seas Prestige
Seven Seas Grandeur
Seven Seas Spendor
Seven Seas Explorer
Seven Seas Voyager
Seven Seas Mariner
Seven Seas Navigator
I'm interested in them all!
I'm lost - I need lots of guidance here.
19
Which destination(s) are you interested in?* This field is required.Not all ships serve all locations, but your selections will help us provide the best recommendations to you.
Africa & Arabia
Asia
Australia & New Zealand
South Pacific
Alaska
Bermuda
Canada & New England
Caribbean & Panama Canal
South America
Mediterranean
Northern Europe
Transoceanic Crossings
Grand Voyages
A World Cruise
20
What about duration?* This field is required.
7-9 Nights
10-14 Nights
15-20 Nights
21+ Nights
21
What is your maximum budget for this trip? Feel free to describe however is most suited for your situation.
22
How did you find Reliant Cruising?* This field is required.Please select all that apply.
YouTube
ChatGPT
Grok
Other AI
Google
Advert
Friends/Family
Repeat Customer
Other
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