EmailMe Form - Passenger Registration Form

Passenger Registration Form

A Room With A View - Cruise & Travel, LLC - Passenger Registration Form

• Please complete the following registration form. Each passenger name must be written/spelled EXACTLY as it appears on their Proof of Citizenship being used to travel. Name changes/corrections in spelling can result in penalties from the air line and/or travel vendor. Incorrect or incomplete information may lead to denied boarding. It is the sole responsibility of each traveler/passenger to identify and obtain all required travel documents, including proof of citizenship for the entire vacation and have them available when necessary.

For More Information About Secure Flight Program: http://www.tsa.gov/stakeholders/secure-flight-program

Note: You may also upload a photocopy of the VALID Passport (International trip) and/or the VALID Driver's License (Domestic trip) PER TRAVELER below.

• By providing this information, I take full responsibility for providing accurate information for not only myself, but other family members that I'm providing information for on their behalf. I authorize my travel consultant to accept the travel supplier contract/terms and conditions on my/our behalf while completing the online check-in when available. (Please initial in box if you agree. Write "no" if disagree.) *
Name of Travel Consultant You Are Working With *
• Name of trip: i.e. Destination, Hotel, Ship or Tour Name, Group Name, etc. *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

This is the address for every passenger listed on this form. If you are traveling with others not residing here, they will need to complete and submit a separate form submission.
Passenger/Traveler # 1 - Name as appears on Valid Passport
First Middle Last
Date of Birth *
Gender *
Passport Expiration Date
The date your current passport expires on. Please list in this format: DateMonth (first 3 letters)Year. For example: 01JAN2024
Valid Passport Number
Country of Birth *
Citizen of *
Passenger/Traveler # 1 - Name as appears on Valid Driver's License or other government issued photo ID for domestic travel only
First Middle Last
Phone *
### - ### - ####
Cell Phone *
### - ### - ####
Email *
Would you like to receive travel promotions, sales and tips via email? *
Yes
No
Any medical or special requirements; including pregnancy? *
If none, note "none" in box
Emergency Contact Person - Name and Phone # *
Note at least one emergency contact person for your family (that is not traveling with you on this trip.)
Cruise line past passenger / Air line frequent flyer # (s):
Indicate name of air line or cruise line with the #
Upload a photocopy of VALID Passport.
Or, government issued Photo ID, i.e. Driver's license, for Domestic trips ONLY.
Passenger/Traveler # 2 - Name as appears on Valid Passport
First Middle Last
Date of Birth
Gender
Valid Passport Number - Passenger # 2
Passport Expiration Date
The date your current passport expires on. Please list in this format: DateMonth (first 3 letters)Year For example: 01JAN2024
Country of Birth
Citizen of
Passenger/Traveler # 2 - Name as appears on Valid Driver's License
First Middle Last
Email
Cell Phone
### - ### - ####
Any medical or special requirements; including pregnancy?
If none, note "none" in box
Cruise line past passenger / Air line frequent flyer # (s):
Indicate name of air line or cruise line with the #
Upload a photocopy of VALID Passport.
Or, government issued Photo ID, i.e. Driver's license, for Domestic trips ONLY.
Passenger/Traveler # 3 - Name as appears on Valid Passport
First Middle Last
Date of Birth
Gender
Valid Passport Number - Passenger # 3
Passport Expiration Date
The date your current passport expires on. Please list in this format: DateMonth (first 3 letters)Year For example: 01JAN2024
Country of Birth
Citizen of
Passenger/Traveler # 3 - Name as appears on Valid Driver's License
First Middle Last
Any medical or special requirements; including pregnancy?
If none, note "none" in box
Cruise line past passenger / Air line frequent flyer # (s):
Indicate name of air line or cruise line with the #
Upload a photocopy of VALID Passport.
Or, government issued Photo ID, i.e. Driver's license, for Domestic trips ONLY.
Passenger/Traveler # 4 - Name as appears on Valid Passport
First Middle Last
Date of Birth
Gender
Valid Passport Number - Passenger # 4
Passport Expiration Date
The date your current passport expires on. Please list in this format: DateMonth (first 3 letters)Year For example: 01JAN2024
Country of Birth
Citizen of
Passenger/Traveler # 4 - Name as appears on Valid Driver's License
First Middle Last
Any medical or special requirements; including pregnancy?
If none, note "none" in box
Cruise line past passenger / Air line frequent flyer # (s):
Indicate name of air line or cruise line with the #
Upload a photocopy of VALID Passport.
Or, government issued Photo ID, i.e. Driver's license, for Domestic trips ONLY.
Passenger/Traveler # 5 - Name as appears on Valid Passport
First Middle Last
Date of Birth
Gender
Valid Passport Number - Passenger # 5
Passport Expiration Date
The date your current passport expires on. Please list in this format: DateMonth (first 3 letters)Year For example: 01JAN2024
Country of Birth
Citizen of
Passenger/Traveler # 5 - Name as appears on Valid Driver's License
First Middle Last
Cruise line past passenger / Air line frequent flyer # (s):
Indicate name of air line or cruise line with the #
Any medical or special requirements; including pregnancy?
If none, note "none" in box
Upload a photocopy of VALID Passport.
Or, government issued Photo ID, i.e. Driver's license, for Domestic trips ONLY.
Note any comments, questions, concerns here:

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