EmailMe Form - ROUTE 66 & CALIFORNIA ZEPHYR PRIORITY RESERVATION

Name *

Prefix First Middle Last Suffix

What is your birth date: *

MM / DD / YYYY

Address *

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

Email *

Confirm

Mobile Phone

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

Home Phone *

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

Please tell us which phone to use when we need to call you? *

Home Phone

Mobile Phone

My Home Phone is my Mobile Phone

Special Needs:

Please let us know if there is any special needs that we need to be aware of such as scooters, walkers, cpap, wheelchair, etc.

TRAVEL COMPANION INFORMATION

Will you be traveling with a companion? *

Yes, I will be traveling with my partner

Yes, but they will submit their own reservation

No

Rooming-Double Room/Sharing

Please give us the name of the individual who you will rooming with if they will be submitting a separate registration form and they will be billed separately.

Rooming -- Partner's Name on same registration

First Last

Partner's birth date:

MM / DD / YYYY

Partner's Email

If you wish them to get a copy of emails and invoices.

Partner's Phone

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

Partner's Phone

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

Partner's Special Needs:

Please let us know if there is any special needs that we need to be aware of such as scooters, walkers, cpap, wheelchair, etc.

WHICH OPTON INTERESTS YOU MOST?

Route 66 Motorcoach Adventure Central Valley to Chicago with return airfare.

Route 66 & California Zephyr Road & Rail Adventure Central Valley to Chicago with California Zephyr return.

Fly to Chicago and return aboard the California Zephyr

NOTE:
All registrants will automatically receive updates and information on all available tour options.

ROOM PREFERENCE *

KING/QUEEN/DOUBLE BED

TWO BEDS

SINGLE ROOM

Please choose one

Do you require a handicapped room *

Yes

No

TRAVEL INTERESTS
What interests you about this tour?

HOW DID YOU HEAR ABOUT THIS TOUR? *

ACKNOWLEDGEMENT *

I understand myy Priority Reservation Deposit is fully refundable.

I understand final pricing, hotel information, and complete package details will be released at a later date.

I understand my deposit secures my place on the Priority Interest List.

I understand that once pricing becomes available, I will have 30 days to accept

PRIORITY RESERVATION DEPOSIT

1 Traveler $100

2 Travelers $200

I approve charging my credit card for credit card for the Priority Reservation Deposit for me (and my partner).

Please charge my credit card for the refundable deposits - Terms and conditions apply.