Gary & Theresa's 2018 Travel Club Douro River Wine & Culture tour

This form is to allow you to provide Dream Vacations Travelperks with your exact traveler information in an easy to follow format. Use of this form is 100% optional as we are always happy to talk with you and collect this information by phone or in person.

My Vacation Specialist Is: * 🛈

All of our agents are happy to help you with this wonderul tour. Theresa Graham, one of your hosts, will be working with you once your reservation is complete. You can reach Theresa at t.graham@dreamvacations.com or 541-349-0036 x201

Please ENTER FULL LEGAL Information (as it appears on your passport) for each traveler. No nick names, initials, etc. unless that is how it appears on your travel documents (passports, etc.). You can use this form for up to 3 travelers. If reserving more then one room, please complete the form and then complete additional forms as needed.

LEAD TRAVELER INFORMATION

First Name: * 🛈

Middle Name: 🛈

Last Name: * 🛈

Nick Name:

Gender *

Date of Birth: * +

Citizenship: *

Primary Phone: *

Phone Type *

Will this traveler be more than 23 weeks pregnant ANY TIME during the trip *

Yes

I have special medical or dietary needs: *

Yes Yes

Vacation Insurance: *

Yes - Protect My Vacation Investment

No - I'll Risk It All

Lead Traveler Email: *

Confirm: *

Address • City, State, Zip *

Have You Traveled On AMA Waterways Before? * 🛈

Yes

Past Traveler Membership #s We Should Have:

0/500 words

Is there a 2nd Traveler (There is no single occupancy price - all cabins are billed double occupancy)? *

Yes

Dream Vacations TravelPerks • t.graham@dreamvacations.com • 541-349-0036 x201