CABIN REQUEST DEPOSIT NOTICE
• Please fax this form to (425) 657 1901. After October 17, 2008 rates are subject to change.
• Fax to Attention: Elia Saez – Costco Travel Groups Department
• Please fill out one form for each cabin. Please print clearly
• If more than one credit card, per cabin, is being used fill out separate forms and note persons
who are sharing the cabin.
Names and dates of birth (must be full legal first and last name only)
**Passports are required for all passengers. Names must match passport. Middle names or initials are not used**
LAST NAME, FIRST NAME GENDER Date of Birth U.S. Citizen?
1. _______________________________________________________________ Y/N
2. _______________________________________________________________ Y/N
3. _______________________________________________________________ Y/N
Cabin Category:___________Deck desired:________________
Insurance: Is an option you can purchase with final payment
Special Request: (cabin near another group member, handicap room, special occasion, past passenger # etc.):
_________________________________________________________________________________________________
Credit Card Information: Visa MasterCard American Express
Cardholder Name:______________________________________________________________________
Billing Address: ________________________________________________________________________
________________________________________________________________________
Telephone Number:___________________________Home or Cell (circle one)
Cruise Deposit amount: $200 per cabin
Amount authorizing to charge:___________________________________________________________
Card #:__________________________________________________________Exp:_______/_________
Email address for confirmation___________________________________________________________
Celebrity X Cruises
Pacific NW Red Hat FunVention 2009
Hosted by: Red Hat Adventures NW
3 Night Pacific Northwest Cruise – Celebrity Mercury
Departing from: Seattle, WA – Departing date: October 2, 2009
Group Leaders: Lise Thom (503) 252 7670 –lisethom@aol.com
Jean Mounsey (360) 904 0332 – j.mounsey@comcast.net
www.redhatadventuresnw.com
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