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Norwegian Mediterranean GetAway 2020
**A valid Passport is REQUIRED*
Cruise Ship Name
Departure Date
MM
/
DD
/
YYYY
Number of Rooms
*
One
Two
Three
Cabin Request
*
Interior - $1855/ Per Person
Balcony - $2772/ Per Person
Ocean - $2585/ Per Person
**THIS RATE IS BASED ON DOUBLE OCCUPANCY - Single occupancy is 200% of the rate shown**
***DOES include Port Taxes and Fees **
Room Types & Occupancy
Only required if booking more than one room AT registration
Room #1
Guest #1 - Name as printed on Passport
*
First
Middle
Last
Suffix
Birthdate
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Norwegian Latitude Number
Loyalty Program ID Number for Prior Clients
Guest #2 - Name as printed on Passport
First
Middle
Last
Suffix
Birthdate
MM
/
DD
/
YYYY
Gender
Male
Female
Norwegian Latitude Number
Loyalty Program ID Number for Prior Clients
Guest #3 - Name as printed on Passport
First
Middle
Last
Suffix
Birthdate
MM
/
DD
/
YYYY
Gender
Male
Female
Norwegian Latitude Number
Loyalty Program ID Number for Prior Clients
Guest #4 - Name as printed on Passport
First
Middle
Last
Suffix
Birthdate
MM
/
DD
/
YYYY
ROOM 2 INFORMATION
Only complete if applicable
Room Type
Only required if booking more than one room AT registration
Guest #1 - Name as printed on Passport
First
Middle
Last
Suffix
Birthdate
MM
/
DD
/
YYYY
Gender
Male
Female
Guest #2 - Name as printed on Passport
First
Middle
Last
Suffix
Birthdate
MM
/
DD
/
YYYY
Gender
Male
Female
ROOM 3 INFORMATION
Only complete if applicable
Room Type
Only required if booking more than one room AT registration
Guest #1 - Name as printed on Passport
First
Middle
Last
Suffix
Birthdate
MM
/
DD
/
YYYY
Gender
Male
Female
Guest #2 - Name as printed on Passport
First
Middle
Last
Suffix
Birthdate
MM
/
DD
/
YYYY
Gender
Male
Female
Guest #1 Information
This is the person who will be the main point of contact
Mailing Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Email
*
Telephone Number
*
###
-
###
-
####
Cell Number
###
-
###
-
####
Credit Card Information
Please double check the information you provide
Permission to Use Credit Card for Future Payments
*
Yes
No
Authorize Amount to Charge CC
*
$
Dollars
.
Cents
Must meet at least the deposit requirements
Name as it appears on Credit Card
*
First
Last
Billing Address of Credit Card
*
Street Address
City
State / Province / Region
Postal / Zip Code
Fill out only if different than mailing address
Cruise Only
I/We will make my own flight arrangements and book a minimum of 1 night hotel stay
**Name
First
Last
Provide name of those you are traveling with or wish to room near
**Name
First
Last
Provide name of those you are traveling with or wish to room near
We wish to have:
Handicap Room
Adjacent Room
One Bed
Two Beds
Require wheelchair(s) at airports:
No
Yes*
*Passenger Name
Dining Preference
*
Early (1st ) Seating
Late (2nd ) Seating
Open Seating
TRAVEL INSURANCE - Includes Trip Cancellation, Interruption, Medical, & Baggage Insurance: (Please Check)
*
Yes, I/we wish to purchase the optional Travel Insurance (Ask LDTG for detailed brochure).
No, I/we do not wish to purchase any form of Travel Insurance, and I/we assume full responsibility for all penalties and administrative charges should I/we cancel for any reason.
By signing my name in this box it certifies that I give authorization to charge the credit card listed above and have read & understood: Travel Insurance Offer + Terms & Conditions of Booking as stated on page two (2).
*
Clear