Sign-up Form ~ Bahamas/Florida Deaf Cruise 2016
PLEASE PRINT CLEARLY: (must fill out all information including address, etc.)
Your Name (Match Name as Passport Book): _____________________________________________________ Date of Birth: _____ / _____ / _____
Do you have passport book? (check one)
Are you (check one)
□ Deaf / HOH?
□ No
□ Will Apply soon
□ Hearing?
□ Yes (please make a copy and mail with this form)
Are you from Tennessee Deaf for the Deaf School? (check one)
□ No
□ Yes
Is it your first time cruise with Royal Caribbean (RC)? (check one)
□ Yes
□ No, how many times have you cruised with RC? ____________
Do you have Crown & Anchor membership with RC? (check one)
□ No
□I
Is your spouse going with you? (check one)
□ No
don’t know
□ Yes, #_______________________________
□ Yes (go to 2nd page, see the gray box)
Email Address: ________________________________________________________________________________________________________
Mailing Address: ___________________________________________________________________________ Apt. # (If any) _______________
City: _____________________________________________________________________ State: ______________ Zip: ____________________
Your phone number:
(check one)
□ Voice
□ VP
(_____________) ________________________________________________
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Special Needs:
Medical: ____________________________________________________________________________________________________
(wheelchair, CPAP, diabetic, medication needs refrigator, low vision, blind, etc.)
Dietary: ____________________________________________________________________________________________________
(vegetarian, gluten free, lactose-free, etc.)
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Emergency Contact Information:
Please provide the name of someone who is not traveling with you.
Name: ________________________________________________________________________________________________________________
Relationship to you: ____________________________________________________________________________________________________
(parent, daughter, sister, friend, etc.)
Mailing Address: ___________________________________________________________________________ Apt. # (If any) _______________
City: _____________________________________________________________________ State: ______________ Zip: ____________________
Phone number:
(check one)
□ Voice
□ VP
(_____________) ________________________________________________
Email address: ________________________________________________________________________________________________________
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Type of Stateroom (cabin): (check one) □ Inside~$544 pp □ Large Inside~$564 pp
Large Ocean View~ □ $594 pp
□ $624 pp
Any request your cabin*: ________________________________________________________________________________________________
(near elevator, midship, front of ship, back of ship, name of friends that you want to be near their cabin, etc.)
Type of Bed for Stateroom: (check one)
□ One Bed (Together)
□ Two Beds (Apart)
NOTE: If you are traveling alone: Your rate will be much higher. (You can add a roommate later, if find one, let me know then your rate will be reduced.)
Name of Roommate(s) who will share cabin with you: (your roommate will have to fill her/his separate passenger information form) ___________________
______________________________________________________________________________________________________________________
*Once your deposit or total of payment reach $180 per person, then I can check if there are available or near as possible, but not guarantee. Early deposit would be better chance.
~1~
(over)
If your spouse is going cruise with you, please fill this gray box.
Spouse’s Name:_____________________________________________________________ Date of Birth: _____ / _____ / _____
Does spouse have passport book? (check one)
Is spouse (check one)
□ Deaf / HOH?
□ No
□ Hearing?
□ Will Apply soon
□ Yes (please make a copy and mail with this form)
Is your spouse from Tennessee Deaf for the Deaf School? (check one)
□ No
□ Yes
How many times have your spouse cruised with RC? _____________
Does Spouse have Crown & Anchor membership with RC? (check one)
□ No
□I
don’t know
□ Yes, #_______________________________
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Deposit Payment:
Make to L’ATTITUDES TRAVEL) (Deposit is $80 per person – check, cashier check or money order only for deposit. If you want to pay
$180, my suggestion to write a check of $80 per person and call me to give me your debit/credit card to charge the rest after we receive
the check of deposit. (NOTE: all deposits will be deducted from the group cruise rate)
Check one:
□ Check
□
Money Order
□ Cashier Check
Amount of $ ________________
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Automatic Monthly Payment Plan:
Check here _____ Yes, I want to sign up for automatic monthly payment with my Debit/Credit card toward Cruise Package only. Please
send me Debit/Credit Card Authorization form.
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I agree to notify L’Attitudes Travel/Maria Michaelson, Travel Concierge in writing or emailing of any changes of my cruise package or
cancelling my cruise. It is my understanding that there is a cancellation fee of $80 per person with L’Attitudes Travel, whenever I cancel
my cruise any time.
_______________________________________________________________________________________
Your Signature
Date
_______________________________________________________________________________________
Your Spouse’s Signature (if going with you)
Date
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Any Comments: ________________________________________________________________________________________________________
How did you find out about us?
Check one:
□ Facebook
□ Other:
□ Google / Internet
□ Friend:
(name) _______________________________________
(explain) ___________________________________________________________________________
After complete the Passengers Info form, checks for deposit & copy of passport book (if any)
Mail to: L’Attitudes Travel
Attn: Maria Michaelson, Agent
2045 E. Dorothy Lane
Kettering, OH 45420
Any Questions ~ Call Maria Michaelson, Travel Concierge (Agent) at 937-630-4844 or email at [email protected]
Maria
03/17/15