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Polka Dots Group Cruise
Carnival Fantasy sailing October 12 - 16, 2017
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. It is imperative to list your FULL LEGAL NAME.
*Title
Choose a Title
Mr.
Ms.
Mrs.
Miss
Dr.
*Legal 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:
*Emergency Contact & Number:
Past Guest Number:
*How many guests are in your cabin?
How many guests are in your cabin?
1 - Single Occupancy
2 - Double Occupancy
3 - Triple Occupancy
4 - Quad Occupancy
*Your cabin preference:
Choose a cabin preference
Inside Stateroom 4C (no window)
Inside Stateroom 4D (no window)
Ocean View Stateroom 6B
Ocean View Stateroom 6C
Ocean View Stateroom 6D
Do you need your cabin near another guest?
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?
Choose one
Yes
No
Need More Information
Guest 1 Deposit/Payment Information:
*Has your group leader explained the terms of deposit, cancellation, and changes?
Choose
Yes
No
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. You may feel free to phone in your credit card information to Mendy Johnson at 251-414-4626.
Card Brand:
Choose a Card
American Express
Discover
Master Card
Visa
Card Number:
Expiration Month:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Year:
Year
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
CVV:
Full Billing Address:
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. It is imperative to list your FULL LEGAL NAME.
Title
Choose a Title
Mr.
Ms.
Mrs.
Miss
Dr.
Legal Name:
Address Line 1:
Apt or Suite:
City, State, Zip
Phone:
Alt Phone:
Email:
Receipt of payment will be emailed.
Date of Birth:
Emergency Contact & Number:
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?
Choose one
Yes
No
Need More Information
Guest 2 Deposit/Payment Information:
Has your group leader explained the terms of deposit, cancellation, and changes?
Choose
Yes
No
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. You may feel free to phone in your credit card information to Mendy Johnson at 251-414-4626.
Card Brand:
Choose a Card
American Express
Discover
Master Card
Visa
Card Number:
Expiration Month:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Year:
Year
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
CVV:
Full Billing Address:
Guest 3 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. It is imperative to list your FULL LEGAL NAME.
Title
Choose a Title
Mr.
Ms.
Mrs.
Miss
Dr.
Legal Name:
Address Line 1:
Apt or Suite:
City, State, Zip
Phone:
Alt Phone:
Email:
Receipt of payment will be emailed.
Date of Birth:
Guest 3 Deposit/Payment Information:
Has your group leader explained the terms of deposit, cancellation, and changes?
Choose
Yes
No
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. You may feel free to phone in your credit card information to Mendy Johnson at 251-414-4626.
Card Brand:
Choose a Card
American Express
Discover
Master Card
Visa
Card Number:
Expiration Month:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Year:
Year
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
CVV:
Full Billing Address:
Guest 4 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. It is imperative to list your FULL LEGAL NAME.
Title
Choose a Title
Mr.
Ms.
Mrs.
Miss
Dr.
Legal Name:
Address Line 1:
Apt or Suite:
City, State, Zip
Phone:
Alt Phone:
Email:
Receipt of payment will be emailed.
Date of Birth:
Guest 4 Deposit/Payment Information:
Has your group leader explained the terms of deposit, cancellation, and changes?
Choose
Yes
No
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. You may feel free to phone in your credit card information to Mendy Johnson at 251-414-4626.
Card Brand:
Choose a Card
American Express
Discover
Master Card
Visa
Card Number:
Expiration Month:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Year:
Year
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
CVV:
Full Billing Address:
List any additional comments below:
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