West Coast Hash Cruise

*Cabin Type:

Ocenaview Cabin (Category 6C)
Inside Cabin (Category 4C)
Other - See My Comments in ``Notes For Babe`` Below

Guest 1 Traveler Information

Please list your FULL LEGAL NAME as it is listed on your Proof of Citizenship Document.  For example, if you are using a Passport as Proof of Citizenship, please list your name EXACTLY as it is listed on that document.  If using a Birth Certificate/Driver License Combination, your name should match the name listed on your Birth Certificate, unless your name has been legally changed due to marriage or some other circumstance. In that case, you will also need to bring a copy of your marriage license or other legal document supporting the name change. It is imperative to list your  FULL LEGAL NAME.

*Title

*Legal Name:

Hash Name

*Address Line 1:

Apt or Suite:

*City, State, Zip

*Phone:

Alt Phone:

*E-Mail:

Valid e-mail is required

Receipt of payment will be emailed.

*Date of Birth:

Past Guest Number:

*How many guests are in your cabin?

Names of other occupants in room if known:

Celebrating a special occasion?

Any Medical or Dietary Needs?

I understand that by clicking `no`, I have been offered and declined trip insurance protection.

*Interested in purchasing trip insurance?

Gratuities ($51.80) Applies to everyone in the cabin

I will prepay these along with my cruise.
I will wait and have them charged to my onboard charge account

Guest 1 Deposit/Payment Information:

*Do you understand the terms of deposit, cancellation, and changes?

If paying by check, please make payable to Springdale Travel, and mail this form with check attached to:
Springdale Travel, 958 Montlimar Drive, Mobile, Alabama 36609.
If paying by credit/debit card, please fill out the form data below and click on Submit below this form will be transferred to a secure web site for our retrieval.

Card Brand:

Card Number:

Expiration Month:

Expiration Year:

CVV:

Full Billing Address if different from above:

Guest 2 Traveler Information

Please list your FULL LEGAL NAME as it is listed on your Proof of Citizenship Document.  For example, if you are using a Passport as Proof of Citizenship, please list your name EXACTLY as it is listed on that document.  If using a Birth Certificate/Driver License Combination, your name should match the name listed on your Birth Certificate, unless your name has been legally changed due to marriage or some other circumstance. In that case, you will also need to bring a copy of your marriage license or other legal document supporting the name change. It is imperative to list your  FULL LEGAL NAME.

Type `same` in any field if the information is the same as what was entered for Guest 1.

Title

Legal Name:

Hash Name

Address Line 1:

Apt or Suite:

City, State, Zip

Phone:

Alt Phone:

Email:

Receipt of payment will be emailed.

Date of Birth:

Past Guest Number:

Celebrating a special occasion?

Any Medical or Dietary Needs?

I understand that by clicking `no`, I have been offered and declined trip insurance protection.

Interested in purchasing trip insurance?

Guest 2 Deposit/Payment Information (if paying with different card as Guest 1)

Do you understand the terms of deposit, cancellation, and changes?

If paying by check, please make payable to Springdale Travel, and mail this form with check attached to:
Springdale Travel, 958 Montlimar Drive, Mobile, Alabama 36609.
If paying by credit/debit card, please fill out the form data below and click on Submit below this form will be transferred to a secure web site for our retrieval.

Card Brand:

Card Number:

Expiration Month:

Expiration Year:

CVV:

Full Billing Address if different from above:

Title

City, State, Zip

Receipt of payment will be emailed.

Notes for Babe

Comments:

Create Your Own Form
using this Template

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