Babe`s Grand Canyon Road Trip

Traveler Information

*Lead Traveler:

Hash Name

*Address Line 1:

Address Line 2:

Apt. or Suite No.

*City:

State or Province

*Zip Code:

*Phone:

*E-Mail:

*Occupancy Type

*Bed Type:

Based on availability

*Number of Travelers on this reservation

If more than 1, list below.

Name of Traveler #2:

Hash Name

Name of Traveler #3:

Hash Name

Name of Traveler #4:

Hash Name

Comments:

TRAVEL INSURANCE: It is highly recommended that each traveler purchase insurance. Click this link for details.

Payment Information

Please refer to your registration form for the deposit & payment amounts and also for the payment schedule.
NOTE: A 3.5% fee imposed by the credit card companies will be added to each card transaction. 
YOU MAY PAY BY CHECK TO AVOID THESE FEES. JUST INDICATE PAYING BY CHECK IN COMMENTS BOX AND MAIL THE CHECK TO THE ADDRESS ON THE WEB SITE. BABESHASHCRUISE.COM
Once the payment is invoiced, you will receive a receipt via email.

*Paying by:

Payment Amount today:

3.5% will be added

Card Number:

Please put dashes between sets

Name on Card:

Please put dashes between sets

Expiration Month:

Expiration Year:

Card Brand:

By submitting this form, you are agreeing to all terms and conditions and no money is refundable.

Create Your Own Form
using this Template

Want the ability to collect information with an
online form that looks like this one?