Passenger Information Forms

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Exlusivetours GENERAL MEDICAL FORM

GUESTS ARE TO FILL OUT ONE PASSENGER INFORMATION FORM PER PERSON

This form must be completed by the passenger and submitted to us at least 100 days prior to departure. You will be subject to a name change fee if the form is not completed by the deadline. Please note that we require complete flight detail from the time you leave home until the time you return home, even if you are flying to another destination before or after your Exclusive Tours holiday.

We cannot release documents without this form being submitted to us.

NOTE: Names must show as per passport. Misinformation regarding names on passports will result in a minimum $75 revision fee per person.

* = required to submit.

 
CONTACT INFORMATION:
*Title
*First Name:
*Last Name:
*Address #1:
Address #2:
*City:
*Province/State:
Other:
*Postal Code/Zip:
*Country:
*Phone:
*Email:
Gender:
   
CRUISE INFORMATION:
*Cruise you are booked on:
 
*Cabin Number:
*Booking Number:
*Embarkment Date:
   
Do you have any dietary restrictions, food or drug allergies?
 
Are you celebrating any special event, birthday-anniversary - etc?
 
   
FLIGHT INFORMATION:
*Airline and Flight Number:
*Depart from Where:
*Departure Date:
*Departure Time:
*Arrive from Where:
*Arrival Date:
*Arrival Time:
   
PASSPORT INFORMATION:
*Passport Number:
*Citizenship:
*Date of Issue:            
*Place of Issue:
*Date of Expiry:            
*Date of Birth:            
Occupation:
   
MEDICAL/TRAVELLERS INSURANCE - PLEASE PROVIDE THE FOLLOWING INFORMATION
TRAVEL INSURANCE: We strongly recommend that all passengers be adequately insured for emergency medical expenses and emergency evacuation for the specific areas they will be visiting. We also strongly recommend that all passengers purchase comprehensive insurance which would include coverage for cancellation, trip disruption, baggage and personal property.
Name of Insurance company:
Insurance Phone Number: (include country code and area code)
Policy Number:
   
EMERGENCY CONTACT INFORMATION
Name:
Relationship to traveler:
Phone Number: (include country code and area code)
   
PAST PASSENGER
Are you a past passenger with this cruise line?
 


  If Yes, Do you know your past 'CLUB' number?
   
PASSENGER TICKET CONTRACT
 
 
 

(If you would like a copy of this information please print the page BEFORE you submit the form)