Gina Tour Reservation Form

Your Information

Tour name/Group name:

Tour Date:

Enter Your Tour Name

Travel Agent/Group Leader:

Room Type Request:

Enter Room Type Needed:

Your Travel Agent

Select Destination(s):

Preferences

Room Sharing:

Single supplement for the additional cost quoted.

I will share a room with (enter roommate's name)

I will share with another traveler (Share not guaranteed)

Enter roommate’s name:

Smoking Option:

Non-Smoking

Smoking

Personal Details

First name:

Last name:

Address

City

State/Province

Zip/Postal

Country

Address

Phone Number:

Email

Passport Number:

Country of Issue:

Date of Birth:

Issue Date:

Expiration Date:

Emergency Contact

First Name:

Last Name:

Phone Number:

Relationship to Traveler:

Enter relationship to the traveler

The Payment Details

Payment Type

Amount

Credit Card

Billing Address

City

State/Province

Zip/Postal

Country

Billing Address

Do you want make payment for other travelers?

Payment For Other Travelers

First Name

Last Name

Payment Type

Enter Amount

Credit Card

Billing Address

City

State/Province

Zip/Postal

Country

Billing Address

Pay For Another Traveler Remove

Total Amount

Gina Tour Reservation Form

Payment For Other Travelers

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