EmailMe Form - Registration for CODA Family Cruise 2019

Deadline July 14, 2017 or until sold out for Deposit. The sooner, the better.

New Info: Norwegian is offering $50 deposit per guest until June 5th, 2017 to even reserve a stateroom. After June 5th, it will go back to $250 per guest. Grab it!
Deaf Parent of CODA *
First Last
Email *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone Number *
### - ### - ####
If you do not have a phone number, type 000-0000 and type a note on the bottom of this page and explain why.
Skype name:
If you are deaf and do not have VP and are from other countries out of USA, you can give us your Skype name where we can contact you.
Cell Phone Text Number
### - ### - ####
for Texting Purpose.
Emergency Contact Name: *
First Last
How is your emergency contact name related to you? *
Parents, Grandparents, Sister, Friend, etc.
Emergency Contact Phone Number: *
### - ### - ####
Your Birthdate: *
MM / DD / YYYY
Are you? *
Female
Male
Your Citizenship: *
Are you? *
Deaf
Hard of Hearing
Hearing
Bed Configuration?
Twin Beds Converted into Queen Bed (together)
Separate Twin Beds
Other Configuration? (Type Below)
Guest Name 2:
First Last
Guest 2 Email:
Guest 2 Birthdate:
MM / DD / YYYY
Guest 2:
Female
Male
Guest 2 Citizenship:
Guest 2:
Deaf
Hard of Hearing
Hearing
How related to CODA (Child of Deaf Adult)?
Other Deaf Parent of CODA
Other Hearing Parent of CODA
This child is CODA.
Guest Name 3:
First Last
Guest 3 Email:
Guest 3 Birthdate:
MM / DD / YYYY
Guest 3:
Female
Male
Guest 3 Citizenship:
Guest 3:
Deaf
Hard of Hearing
Hearing
How related to CODA (Child of Deaf Adult)?
This Child is CODA
Other Friend or Relatives
Other (Please Explain)
Guest Name 4:
First Last
Guest 4 Email:
Guest 4 Birthdate:
MM / DD / YYYY
Guest 4:
Female
Male
Guest 4 Citizenship:
Guest 4:
Deaf
Hard of Hearing
Hearing
How related to CODA (Child of Deaf Adult)?
This Child is CODA
Other Friend or Relatives
Other (Please Explain)
Disability or Special Needs for any guests in this stateroom?
Accessible Stateroom, diabetes, or any special needs (the cruise line might be able to help)?
Choose if any of you are: *
Age 55+
An Active duty or retired U.S. Military or Canadian Forces
An Active duty or retired member of local or state/province Law Enforcement, Fire Dept. or EMT
AARP Member
None of the Above.
Sometimes you might qualify for discounts.
Which Cruise Lines have any of you been on before? *
Carnival
Celebrity X
Disney
Holland America
MSC Cruise
Norwegian
Royal Caribbean
None (First Time Cruise)
Other
Sometimes there is a discount if you were past guest for the cruise line you were on before.
1st Deposit $50 Per Stateroom is due by August 15, 2017

2nd Deposit of $450 Per Stateroom are due by April 2, 2018, but the sooner the better so you can reserve which stateroom number you want. If you decide to pay monthly, then when it goes to $500 deposit per stateroom then you can reserve the stateroom number you want too.

Final Payment is Due by April 2, 2019
The Price includes cruise fare, Hotel, transfers, taxes, port fees, group shirts, group picture, and two group amenity bonuses of gratuity being waived and $50 Excursion Credits. Final Payment is due on July 28, 2019. Which Stateroom do you want (If Available): *
2 Guests Inside Stateroom IA ($2,521.43 Per Guest)
3 or 4 Guests Inside Stateroom IA (Ask for Quote)
2 Guests Oceanview (Window) Stateroom OA ($2,834.59 Per Guest)
3 or 4 Guests Oceanview (Window) Stateroom (Ask for Quote)
2 Guests Balcony Stateroom BA ($3,304.31 Per Guest)
3 Guests Balcony Stateroom (Ask for Quote)
Other Stateroom (Ask for Quote)
The third guest or more in the same stateroom usually cost less than the first and second guest's rate. There will be gratuity (tip) charge for third and fourth guest which is about $97.93 per guest for whole week. It is waived (free) for the first two guests).
Do you want BookSafe Travel Protection Plan? We would highly recommend it. What if your child get sick or hurt and you can't go on the cruise? What if you have emergency surgery before cruise? etc. With this protection, if there is true emergency, you will get refund. If you cancel for any other reason, on the standard travel protection you will get 75 percent credit toward your future cruise or on the premium travel protection, you will get 90 percent credit toward your future cruise. *
Yes for 2 Guests Inside Stateroom IA Standard Travel Protection ($179 Per Guest)
Yes for 2 Guests Inside Stateroom IA Platinum Travel Protection ($239 Per Guest)
Yes for 3 or 4 Guests Inside Stateroom IA (Ask for Quote)
Yes for 2 Guests Oceanview (Window) Stateroom OA Standard Travel Protection ($209 Per Guest)
Yes for 2 Guests Oceanview (Window) Stateroom OA Platinum Travel Protection ($269 Per Guest)
Yes for 3, or 4 Guests Oceanview (Window) Stateroom (Ask for Quote)
Yes for 2 Guests Balcony Stateroom BA Standard Travel Protection ($260 Per Guest)
Yes for 2 Guests Balcony Stateroom BA Platinum Travel Protection ($320 Per Guest)
3 or 4 Guests Balcony Stateroom (Ask for Quote)
Other Stateroom. (Ask for Quote)
No (Can decide later until 90 days before going on cruise)
Click Here to see Norwegian Cruise Details about BookSafe Travel Protection Plan.
Credit/Debit Card or Personal/Business Check
This will not charge to your card automatically. It will be done manually on cruise line portal. We usually do it within 24 hours. You will be charged for your deposit or whatever you choose below.
What do you want to pay now? (Your Deposit will reduce your Final Payment Due) *
Deposit for 2 Guests Inside Stateroom IA - $50 Per Stateroom then pay $87 a month per guest ($174 a month for both guests) starting in August 2017 to July 2019.
Deposit for 2 Guests Oceanview Stateroom OA - $50 Per Stateroom then pay $100 a month per guest ($200 a month for both guests) starting in March 2017 to July 2019.
Deposit for 2 Guests Balcony Stateroom BA - $50 Per Stateroom then pay $120 a month per guest ($240 a month for both guests) starting in August 2017 to July 2019.
Deposit for 3 or 4 Guests in any Stateroom, please ask for a quote.
Deposit for other stateroom, please ask for a quote.
I do not want to pay monthly. I will pay $50 Deposit per Stateroom then pay the rest later.
I want to go ahead and reserve and get room number for $250 Deposit per Guest (Two guests for a total of $500 Deposit). If you desire monthly payment, it will be lower because of higher deposit you paid. We will let you know the monthly payment
WAIT! New announcement!! Norwegian is offering $50 deposit per guest even to reserve stateroom. I want to grab this now. It is only until July 4. After that it will be back to $250 per guest. If you desire monthly payment, we will let you know.
I Want to Pay a different amount (Put down in box below the different amount)? Only Type in Numbers and no Symbols like $, etc.
If you want to pay in full, please add up what you chose above and put it in the box above.

You will not be able to get your stateroom confirmation number and room number until $250 dollars each guest is paid for due to Norwegian Cruise Policy. If you want to get your stateroom and get your stateroom number now, then choose the $500 Deposit above.
Date you want to start paying each month starting in Sept 2017 to April 2019. *
5th of Each Month (Sept 5th, Oct 10th and so on...)
10th of Each Month (Sept 10th, Oct 10th and so on...)
15th of Each Month (Sept 15th, Oct 15th and so on...)
25th of Each Month (Sept 15th, Oct 25th and so on...)
I do not want to pay each month and pay later.
Your card will be charged manually by us each month if you decide to join. It is a free service. It will not always be on that date as it depends on how much work we have to do. Sometimes it is done the next day or two.
Credit/Debit Type or Personal Check, Money Order/Cashier Check. *
We strongly recommend you to use credit/debit card. Writing a check can delay and maybe miss a deadline.
Credit/Debit Card Number
Enter your 15 Numbers for American Express or 16 Numbers for Visa, MasterCard, and Discover. If you are paying by check, ignore it.
Expiration Date (MM/YY)
CSC (Security Number on back or front of the Card)
It is 3 numbers on the back of Visa, MasterCard and Discover Card. If you have American Express, it is four numbers on the front right side of the card.
Leave any note (if desired)
IMPORTANT:
Remember this is not guaranteed you will get this reservation and that it depends on what is available. We will call you and let you know.

If your reservation is approved, that is your total cost for the cruise that you choosed above. If you chose the one that tells you to ask us for a quote, the total below is not correct. You will only be charged for the deposit or whatever you asked us above on the "What do you want to pay now".

Once we charge your deposit, the total will be the total minus what you paid your deposit for.

If there are errors, we will not be liable and will let you know before we charge your card.

Deadline July 14, 2017 or until sold out for Deposit. The sooner, the better.

1st Deposit $50 Per Stateroom is due by August 15, 2017

Credit/Debit Card or Personal/Business Check

IMPORTANT: