EmailMe Form - Disney Wish Celebration Request

Name *

Legal name as it appears on passport or photo ID, including middle initial or name

Email *

Phone *

Date of Birth *

MM / DD / YYYY

Gender

Male

Female

Address *

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

Second Guest Name

Legal name as it appears on passport or photo ID, including middle initial or name

Date of Birth

MM / DD / YYYY

Required for cruise quote

Gender

Male

Female

Third Guest Name

Legal name as it appears on passport or photo ID, including middle initial or name

Date of Birth

MM / DD / YYYY

Required for cruise quote

Gender

Male

Female

Email, Phone Number and Address of second and third guests if different from first guest information above.

If more than three guests will occupy one stateroom, please add the fourth and fifth guest information below.

Ship Name

Date of Sailing

MM / DD / YYYY

Type of Cabin

Stateroom number, if known

Discounts may be available for the following. Please check all that apply

Castaway Club Member

Military

Police

Fire

Cancellation Policy:

Please note, your deposit is 20% of the cruise fare. There is a group cancellation fee of $50 per person, payable to Travel On A Dream before the reservation can be cancelled or transferred with Disney Cruise Line. (this applies to all bookings made after 11/1/18).

Please note special needs, dietary restrictions, requests, cabin locations, etc.

If you have cruised before, indicate which cruise lines.

Have you previously worked with one of our agents?

Yes

No

If you already have a ToaD agent, please select name

How Did you Find Us?

If referred, please name who referred you.