Twin Gemini's Travel Agency
EmailMeForm
Twin Gemini's Travel NYC Booking & Payment Form
NYC Trip & Broadway Plays
Today's Date
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MM
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DD
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YYYY
Dates of Travel
Name of Broadway Play
Primary Passenger Name
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First
MI
Last
(As it appears on Passport/Government ID)
Date of Birth:
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MM
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DD
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YYYY
Mobile/Home Phone Number
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Email
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Passenger #2
First
MI
Last
(As it appears on Passport/Government ID)
Date of Birth:
MM
/
DD
/
YYYY
Passenger #3
First
MI
Last
(As it appears on Passport/Government ID)
Date of Birth:
MM
/
DD
/
YYYY
Passenger #4
First
MI
Last
(As it appears on Passport/Government ID)
Date of Birth:
MM
/
DD
/
YYYY
Special Request/Needs:
List any special request or needs required for the individuals listed. If there is a special need such as dietary or mobility, please indicate by passenger number.
Seating request, room/cabin type, and/or special occasions can be listed here
Travel Insurance
*
Decline
Send Me a Quote
Total Quote
$
Dollars
.
Cents
Deposit Due Date
MM
/
DD
/
YYYY
Final Due Date
MM
/
DD
/
YYYY
Payment Authorization
Sign and complete this form to authorize Twin Gemini's Travel Agency to process payment(s) to your debit/credit card listed below. Multiple charges may be processed for complex reservations using more than one supplier.
By signing this form you give us permission to process payment from your account for the amount indicated on or after the indicated date.
Please note: Quoted prices are not guaranteed. Prices are subject to change until payment or deposit is processed.
Cardholder Name
*
First
Middle
Last
Suffix
Enter name as it appears on the card. Additional verification may be required if cardholder is not a traveler on this trip.
Name of Travelers
*
Enter the names of travelers for which payment applies. Payment will be split evenly unless stated otherwise.
Billing Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Credit Card Type
*
Please select
VISA
MASTERCARD
DISCOVER
AMERICAN EXPRESS
OTHER
Credit Card Number
*
No breaks or dashes needed
Expiration Date
*
MM
/
YY
CSC
*
For MasterCard, Visa or Discover, its the last three digits in the signature area on the back of the card. For American Express, its the four digits on the front of the card. For Gift Card, enter PIN or 000 if no PIN is listed.
Payment Type
*
Please select
Initial Deposit
Partial Payment
Final Payment
Paid in Full at Booking
Amount Authorized
*
$
Dollars
.
Cents
Payment Plan
*
Please select
Yes - Weekly Payments
Yes - Bi-weekly Payments
Yes - Monthly Payments
NO - I'll contact you for payments
Indicate if you authorize the card above to be charged minimum monthly payment. If selected Twin Gemini's Travel Agency will send a reminder at least 3 days before pending charge.
Final Due Date
*
DD
/
MM
/
YYYY
I/we are aware of any cancellation policies and agree not to dispute or attempt to chargeback any of the signed for and acknowledged charges. Further more, I consent to provide an electronic signature rather than a handwritten signature in connection with my Credit Card authorization. By submitting my signature, I understand that my electronic signature will be binding as though I had physically signed this document by hand. I agree that a printout of this authorization may be accepted with the same authority as the original.
Electronic Signature
*
Clear
Please use your mouse or touch screen to write your signature.
Type Signature Here
*
No breaks or dashes needed
Date
*
MM
/
DD
/
YYYY
Twin Gemini's - "Where all your travel needs are in good hands!"