subject_line
2023 Travel Club - Ireland & Scotland w/Milltary Tattoo - Hosted by Theresa & Gary
Your Vacation Specialists
2023 Travel Club Private Trip to Ireland & Scotland with the Military Tattoo
This form is to allow you to provide 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:
*
Gary
Theresa
Diana
Matt
Montika
Other - Not Listed
All of our agents are happy to help you with this wonderful tour. Gary Smith, one of your hosts, will be working with you once your reservation is complete. You can reach Gary at gary@travelperks.com or 541-349-0036 x5222
Please ENTER FULL LEGAL Information (as it appears on your passport) for each traveler. No nicknames, initials, etc. unless that is how it appears on your travel documents (passports, etc.). You can use this form for up to 2 travelers. If reserving more then one room, please complete the form and then complete additional forms as needed.
LEAD TRAVELER INFORMATION
Will this traveler be more than 23 weeks pregnant ANY TIME during the trip
*
Yes
No
First Name:
*
🛈
Middle Name:
🛈
Last Name:
*
🛈
Nick Name:
Gender
*
Male
Female
I am vaccinated:
*
Yes
No
I have special medical or dietary needs:
*
No
Yes
Yes
Primary Pre-Tour Phone:
*
Phone Type
*
Cell/Mobile
Home
Work
Other
Date of Birth:
*
+
Phone # While On Tour:
Phone Type
Cell/Mobile
Home
Work
Other
Beds:
*
One Bed
Two Beds
Vacation Insurance:
*
Yes - Protect My Vacation Investment
Maybe - I Need more Information
Lead Traveler Email:
*
Confirm:
*
Address • City, State, Zip
*
Additional Passenger information need prior to Travel, but optional at time of deposit
Passport #:
Country of Issue:
Country of Birth:
Nationality:
Date of Issue:
Expiration Date:
🛈
Emergency Contact Name:
Relationship
Phone #:
Is there a 2nd Traveler?
*
Yes
No
TravelPerks •
gary@travelperks
.com
• 541-349-0036 x5222