EmailMe Form - November 2020 - Optometry CE on the Nile

International Travel Alert:

***Travelers are responsible for meeting all document requirements for travel, including all necessary visas. It is important that dates of birth and names are provided EXACTLY as they appear on passports. Passports are required for all travelers, regardless of age, and must be valid for at least **6 months** beyond your travel dates. In the event of an emergency, no other documentation will be accepted for inbound foreign flights. For complete regulations regarding Passport requirements visit www.Travel.State.Gov ***

Lead Passenger Preferred Contact Name *

Prefix First Middle Last Suffix

Number of Guests in Cabin *

Sleeping Accommodations Request *

A double bed is preferred.

Separate beds are preferred.

Lead Passenger Information

Please use this section for the primary contact person for the trip.

Name EXACTLY As It Apppears On Your Passport *

First Middle Last

Include your middle name if it is listed on your passport.

Address *

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

Primary Phone # *

### - ### - ####

This number is my:

Cell

Home

Work

Email *

This email will not be shared or used for any other purpose but for this trip.

Preferred Method of Contact

Email

Phone

Date of Birth *

MM / DD / YYYY

Place of Birth *

(City, State/Province)

Citizenship *

Passengers must be of US or Canadian Nationality.

Passport Number *

If you are applying for a passport, please enter "Pending".

Place of Issue *

(City, State/Province)
If you are applying for a passport, please enter "Pending".

Passport Date of Issue *

Passport Month of Issue *

Passport Year of Issue *

Passport Date of Expiration *

Passport Month of Expiration *

Passport Year of Expiration *

Emergency Contact Info

Please provide the contact information for someone not traveling with you.

Name *

First Last

Phone # *

### - ### - ####

Email

Second Traveler Information (If Applicable)

Name

First Middle Last Suffix

Name exactly as it appears on government issued ID or passport for international travel.

Address

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

Primary Phone #

### - ### - ####

This number is my:

Cell

Home

Work

Email

This email will not be shared or used for any other purpose but for this trip.

Date of Birth

MM / DD / YYYY

Place of Birth

(City, State/Province)

Citizenship

Passengers must be of US or Canadian Nationality.

Passport Number

If you are applying for a passport, please enter "Pending".

Place of Issue

(City, State/Province)
If you are applying for a passport, please enter "Pending".

Passport Month of Issue

Passport Date of Issue

Passport Year of Issue

Passport Date of Expiration

Passport Month of Expiration

Passport Year of Expiration

Emergency Contact Info

Please provide the contact information for someone not traveling with you.

Name *

First Last

Phone # *

### - ### - ####

Email

Special Considerations

Please indicate any special needs, such as food allergies, dietary restrictions, medical considerations, special celebrations taking place during your trip, or anything else we need to know to make your sailing as comfortable and pleasant as possible!

Travel Insurance

*

I understand the importance of Trip Insurance and would like a quote.

I understand the importance of Trip Insurance but am declining coverage at this time.

I have already purchased Trip Insurance from elsewhere.

If you are declining coverage, please initial this box.

Confirmation of Passenger Details

Primary Traveler Initials *

**I have reviewed all of the guest information above for accuracy and confirm that it is correct.***

***By initialing this box, you confirm that you have reviewed your passport information and have provided it here exactly as it appears on your Passport Document. You acknowledge that errors here could result in penalties to change or cancel reservations due to incorrect information, and you acknowledge that you will be responsible for any charges incurred due to not providing correct information.***