Booking form

1st traveller

Trip
 3* hotel  4* hotel

Surname and forename (s):
(as indicated in passport)
 
Man Woman
Date of Birth (dd-mm-yyyy)
Passport no.
Address
Zipcode
City
Country
E-mail address
Telephone
Daytime:
Evening:
Telephone at home
(used only in
case of emergency)
Daytime:
Evening:

Other travellers (eg if you have 4 people, fill only traveller 2, 3 and 4; remaining fields can be blank)

Note: All information should be listed as they appear in passports.


No. Name Surname Man/Woman Date of Birth
2 Man Woman
3 Man Woman
4 Man Woman
5 Man Woman
6 Man Woman



Travel and cancellation insurance

Name insurer:
Policy No:

Single:  yes  no

Comments


Total: €1270



Payment Choice:  PayPal    iDeal    bankoverschrijving

 Send me a copy of this registration form.



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