CABIN REQUEST DEPOSIT NOTICE • Please fax this form to (503)256-8516 or mail to: RHANW, 11320 SE Lincoln St, Portland, OR 97216 or fax to 360 576 1057 no later than January 22, 2010 for inside or outside cabins. (Prices are subject to change after January 22 -deadline extended) If booking a veranda or suite cabin do not wait. Book early to avoid price increase. • Please fill out one form for each cabin. • If more than one credit card, per cabin, is being used fill out separate forms and note persons who are sharing the cabin. • Final Payment due: 7/23/10; Penalties begin 8/23/10 Names and dates of birth (must be first and last legal names only) **Names must match passport (EXCEPT no middle names) or required documentation as stated on www.travel.state.gov ** LAST NAME, FIRST NAME GENDER Date of Birth PAST GUEST NUMBER U.S. Citizen? EMAIL ADDRESS 1. ______________________________________________________________________Y / N_________________________ 2. ______________________________________________________________________Y / N_________________________ 3. ______________________________________________________________________Y / N_________________________ 4. ______________________________________________________________________Y / N_________________________ Cabin Category: _______________________________________________________________ Insurance: Is an option you can purchase with final payment except for those who reside in CA, FL, NY, NC, OR, TX or WA. Other insurance options may be available. Special Request: (cabin near another group member, handicap room, special occasion, special needs, pregnancy, etc): ______________________________________________________________ Credit Card Information: Visa MasterCard American Express *Special note on debit cards: debit cards have maximum daily limits; please verify with your bank that the dollar amount being charged can be processed in one transaction. Cardholder Name: ___________________________________________________ Billing Address: ____________________________________________________ ____________________________________________________ Telephone Number: _____________________________Home or Cell (circle one) Cruise Deposit amount: $150 per passenger Amount authorizing to charge: _____________ Card #: _______________________________________________ Exp: ___ / ____ |
Red Hat Adventures NW Carnival The Fun Ships 4 Night Southern California Cruise - Carnival Cruise Lines - Carnival Paradise Departing from: Los Angeles (Long Beach, CA) - Departing date: October 25, 2010 Group Leaders: Lise Thom (503) 252-7670 – lisethom@aol.com Jean Mounsey (360) 904-0332 - j.mounsey@comcast.net www.redhatadventuresnw.com |