EmailMe Form - New Vacation Reservation Quote and Deposit Form

EmailMeForm

Email address *
Contact phone *
### - ### - ####
Hotel Name or Name of Cruise Ship *
Departure Date *
MM / DD / YYYY
Return Date *
MM / DD / YYYY
Room #1 *
First Middle Last
Please enter legal names as they appear on your passport
Date of Birth *
MM / DD / YYYY
Required for price quoting
Room #1 *
First Middle Last
Please enter legal names as they appear on your passport
Date of Birth *
MM / DD / YYYY
Required for price quoting
Room #2
First Middle Last
Please enter legal names as they appear on your passport
Date of Birth
MM / DD / YYYY
Required for price quoting
Room #2
First Middle Last
Please enter legal names as they appear on your passport
Date of Birth
MM / DD / YYYY
Required for price quoting
Room #3
First Middle Last
Please enter legal names as they appear on your passport
Date of Birth
MM / DD / YYYY
Required for price quoting
Room #3
First Middle Last
Please enter legal names as they appear on your passport
Date of Birth
MM / DD / YYYY
Required for price quoting
Room #4
First Middle Last
Please enter legal names as they appear on your passport
Date of Birth
MM / DD / YYYY
Required for price quoting
Room #4
First Middle Last
Please enter legal names as they appear on your passport
Date of Birth
MM / DD / YYYY
Required for price quoting
Are you going to book your own air? *
Airfare can be added as part of your All Inclusive Land Vacation Package with no additional ticketing fees.

For Cruises and Overseas travel, additional ticketing fees apply.
Would you like to add travel insurance? *
Comments/Requests
Add any special requests to be added on to your reservation
Credit Card will not be processed if we are quoting. It will only be charged once you approve your reservation and it is ready to be confirmed. *
First Last
**Your credit card will not be charged until after you receive your reservation quote and approve it**
Billing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Credit Card - (Will only be charged when plans are confirmed and payment is due) *

Card Number

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Deposit Amount or Full Payment
$ Dollars . Cents
This is not a live payment link. Your credit card is stored securely. I process all payments manually which could take up to 24- 48 hours.
**Credit Card Signature Required to Complete Reservation**

I am giving Cruise Planners-Jeanette Esposito authorization to process my credit card for the amount requested or the amount due by the Cruise Line or Travel Supplier.

In lieu of my credit card imprint, I (card holder) hereby authorize Cruise Planners-Jeanette Esposito to use my credit card information to process payments for the travel as agreed upon with the travel supplier.

I agree to be bound by the Terms and Conditions related to this charge. I understand in the event of cancellation or change that financial penalties may be assessed according to Cruise Planners-Jeanette Esposito or travel supplier's terms. I will not hold Cruise Planners or agent liable for these charges. *
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