**Please use your legal name exactly as it will appear on your passport.
** Reminder that all passports must be valid 6 months past travel return date.
Passenger #1 Full Name
*
First Name
Middle Name
Last Name
Suffix
Date of Birth (day/month/year)
*
/
Day
/
Month
Year
dd/mm/yy
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Passenger #2 Full Name
First Name
Middle Name
Last Name
Suffix
Date of Birth
-
Day
-
Month
Year
dd/mm/yy
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Passenger #3 Full Name
First Name
Middle Name
Last Name
Suffix
Date of Birth
-
Day
-
Month
Year
dd/mm/yyyy
Passenger #4 Full Name
First Name
Middle Name
Last Name
Suffix
Date of Birth
-
Day
-
Month
Year
dd/mm/yyyy
Are all guest traveling Canadian citizens?
Please Select
Yes
No
Home Address:
*
Travel Information
Travel departure date
*
-
Day
-
Month
Year
Date
Travel return date
*
-
Day
-
Month
Year
Date
Name of Resort or Hotel
*
Room Type
*
Ex: Jr. Suite
Preferred Bedding Type
Please Select
2 Double Beds
Queen
King
Any special occasions being celebrated during trip?
Emergency contact phone number
-
Area Code
Phone Number
Are you adding Trip Cancellation Insurance
*
Basic coverage ($69-89 depends on supplier)
Advanced coverage ($100-150 depends on supplier)
Waiving coverage
I agree that I understand that my trip is nonrefundable unless travel insurance is purchased. You must agree or disagree with this to continue.
*
I agree
I disagree
How do you want to apply payment
*
Deposit and pay the remaining balance by due date
Pay in Full
Payment Details
*
Mastercard
Visa
AMEX
Card Information
-
Expiry Date
Security Code
I acknowledge that I have read this form completely and the information I provided is accurate
*
Please Select
Yes
Submit
Should be Empty: