The following information is required to process your registration
All fields must be completed

The name on your airline ticket must be an exact match with the name on your passport.

If the names do not match exactly you may not be permitted to board your flight and/or you may incur additional cost at your own expense.

For your security, credit card information will be collected by phone and submitted by fax

Each traveler will require a completed traveler registration form

 
Traveler Information 
Legal First Name:
 Legal first name as it appears on the passport
Middle Name:
 Legal middle name as it appears on the passport
Last Name:
 Legal last name as it appears on the passport
Gender:
Country of Birth:
Date of Birth:
Passport #:
Passport Expiry:
 Date of expiry must be not less than (6) months from date of departure
  
 IMPORTANT: If you have selected MULTIPLE OCCUPANCY please provide name(s) of other person(s). If you are single, please use NA
Names:
  
Address Information 
Street Address:
Town/City:
Province/State:
Postal:
Country:
Home Phone:
Business Phone:
Cellular Phone:
Email Address:
  
Emergency Contact 
Contact Name:
Contact Phone:
  
Insurance Options 
Non Medical Insurance Plan: Yes   No
 Covers trip cancellation, trip interruption, baggage, flight and travel accident insurance
Deluxe Medical Insurance Plan: Yes   No
 Unlimited emergency medical expenses, cancellation and interruption insurance, including coverage specific to cruise vacations, baggage and personal effects, flight and travel accident insurance
 
 


 
 

 

Rose Warnica - Travelonly
Burlington Cruise Consultants Inc.


"Expect the Exceptional"
P: (905) 632.3404 F: (905) 632.5768 E: [email protected]

TravelOnly Corporate Office: 202-325 West Street, Bldg. A, Brantford ON N3R 3V6