Custom Vacation Booking Form
Please complete the form below when you are ready to book. Once you complete the form we will email you with your vacation details before proceeding with the booking. Please leave blank if it does not apply. *You must have already received a custom quote to fill this form out. If you have not contacted us for your quote, please visit our website www.deeluxevacations.com to complete the custom quote request form.
Please enter your booking code
*
This will typically be a two to three letters followed by 3-5 numbers given by your agent
Travel Dates
*
Please include the travel dates included in your custom quote
Destination
*
Please list where you are traveling to
Selected Hotel/Resort
*
Please list the hotel you selected when working with us
Is this a booking with multiple rooms? Please use multiple forms if payment is different
*
Yes
No
Departure Airport (what city are you flying from?)
*
Please select all items included in your quote. You may select any additional items you'd like to add here (please select all that apply)
*
Flights
Hotel/Resort
Airbnb/Vacation Home
Cruise
Rental Car
Excursions
Event Tickets
Airport Transfers
Lead Traveler (Traveler 1) Full Name
*
First Name
Middle Name
Last Name
Traveler 1 Email
*
example@example.com
Traveler 1 Phone Number
*
Please enter a valid phone number.
Traveler 1 Birthdate
*
-
Month
-
Day
Year
Date
Traveler 1 Gender
*
Male
Female
Other
Traveler 2 Full Name
First Name
Middle Name
Last Name
Traveler 2 Email
example@example.com
Traveler 2 Phone Number
Please enter a valid phone number.
Traveler 2 Birthdate
-
Month
-
Day
Year
Date
Traveler 2 Gender
Male
Female
Other
Traveler 3 Full Name
First Name
Middle Name
Last Name
Traveler 3 Email
example@example.com
Traveler 3 Phone Number
Please enter a valid phone number.
Traveler 3 Birthdate
-
Month
-
Day
Year
Date
Traveler 3 Gender
Male
Female
Other
Traveler 4 Full Name
First Name
Middle Name
Last Name
Traveler 4 Email
example@example.com
Traveler 4 Phone Number
Please enter a valid phone number.
Traveler 4 Birthdate
-
Month
-
Day
Year
Date
Traveler 4 Gender
Male
Female
Other
Traveler 5 Full Name
First Name
Middle Name
Last Name
Traveler 5 Email
example@example.com
Traveler 5 Phone Number
Please enter a valid phone number.
Traveler 5 Birthdate
-
Month
-
Day
Year
Date
Traveler 5 Gender
Male
female
other
Traveler 6 Full Name
First Name
Middle Name
Last Name
Traveler 6 Email
example@example.com
Traveler 6 Phone Number
Please enter a valid phone number.
Traveler 6 Birthdate
-
Month
-
Day
Year
Date
Traveler 6 Gender
Male
Female
Other
Add Travel Insurance
*
Yes, add Travel Insurance
No, do not add insurance
Payment
Please fill in your payment information below. If you are paying a deposit, please only list deposit amount to be charged. Please note that this form does not automatically charge your card and it will be done once your agent reviews the information entered above and gets your Vacation booked. Payment will then be processed during booking and confirmation sent within 15 minutes of your card being charged.
Amount to be charged:
*
(ex: $1,377.99)
Card Type
*
VISA
MasterCard
Discover
American Express
Card Number:
*
(Ex: 5555777788889999)
Expiration Date:
*
Security Code:
*
(Ex 789)
Billing Address (please include full address including street)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Signature required - "Clients" (the individual filling out this form and other travelers listed on this form) understand that this booking is nonrefundable unless Travel Insurance is added. In case of cancellation, all refunds are provided in the form of Travel Credit. Client(s) hereby gives DeeLuxe Vacations consent to book the quoted travel itinerary matching the information provided above. PAYMENT AUTHORIZATION: Client(s) confirms that the credit card information entered above is accurate, that client is the rightful owner of this card, that client has authorization to use this card, and that DeeLuxe Vacations is authorized to charge the amount confirmed on the form above. If you agree with this statement please sign below
*
Thank You!
Once we receive your booking form, we will get your Vacation booked and confirmation sent.
Submit
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