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EmailMeForm
BREATHLESS @ CABO- BEST OF TWO WORLDS
**November 7-11 2020**
******PLEASE NOTE A DEPOSIT IS DUE AT REGISTRATION******
Full Name
*
EXACTLY as it appears on your passport
Date of Birth
*
MM
/
DD
/
YYYY
If registering roommate also , please provide DOB . IF roommate registering separately then please do not answer.
If traveling outside of the United States , please answer the following
Are you an US Citizen?
*
Yes
No
Passport Number
*
*You may place a random nine numbers if you do not have a passport*
PLEASE NOTIFY YOUR TRAVEL AGENT IF YOU DO NOT HAVE A PASSPORT
Passport Expiration Date
*
MM
/
DD
/
YYYY
Name of Roommate(s) or place NA if wish to have single occupancy
*
ROOMMATE -Date of Birth
MM
/
DD
/
YYYY
If registering roommate also , please provide DOB . IF roommate registering separately then please do not answer.
Occupancy & Room Type
*
Single Occupancy Marina View / $1938-pp
Single Occupancy Xhale Club/- $2345-pp
Single Occupancy Xhale Master/$3004-pp
Double Occupancy Marina View/$1069-pp
Double Occupancy Xhale Club/ $1210-pp
Double Occupancy Xhale Master/$1540-pp
* Rate is PER PERSON- based on a 5 day/ 4 night stay and includes all -inclusive stay at Breathless Resort, transfers and travel insurance*
**Stay one free night in all XHALE level rooms when you stay 4 nights**
Would like to add additional days to your travel?
*
Yes
No
Dates of Travel
If you answered yes to the question above, please specify dates between November 4-12 & a REVISED vacation package price will be sent to the email you have provided.
Would you like to add a flight to your package
*
Select One
Yes
No
**If you elect to add AIR to your vacation package an additional $100 is due PER PERSON within 48 hours of receiving the quote**
Departure City
If you answered yes to the question above, please specify the city in which you would like to fly from
Preferred Airline
Known Travel Number
TSA Pre-check/ Global Entry
Physical Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Mailing Address if differs from Physical- ALSO IF TIED TO CREDIT CARD NOTED BELOW
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Phone
*
###
-
###
-
####
Email
*
Roommate email address
Are you interested in a monthly payment plan?
*
Please select
Yes
No
Once your deposit has been received you will be set up on a recurring payment plan based on your remaining balance and number months to final payment- June 2019
If you elected for a payment plan, please indicate which day of the month you elect your payment to be drafted.
Name as it appears on credit card
Physical Limitations
Dietary Restrictions/Allergies
Total
$0.00