ScrapMap - Scrapbooking Cruises and Tours

SELECT YOUR ACCOMMODATIONS

Double
Single: I need help finding a roommate.
Single: I will be rooming by myself. (Single supplement fee applies)

PERSONAL INFORMATION

Please fill in all information as it appears on your legal documents. This is very important to make your vacation planning as easy as possible. * Required Field

First Name: *
Middle Name:
Last Name: *
Nick Name:
Passport #:
Passport Exp. Date:	/ /
Address:
City:
State/Province/Region:
Zip/Postal Code:
Country:
Phone: *
Birth date: (MM/DD/YYYY)	/ /
Email Address: *

First Name:
Middle Name:
Last Name:
Nick Name:
Passport #:
Passport Exp. Date:	/ /
Address:
City:
State/Province/Region:
Zip/Postal Code:
Country
Phone:
Birth date: (MM/DD/YYYY)	/ /
Email Address:

IN CASE OF EMERGENCY

Name:

Phone:

Cell:

SPECIAL REQUESTS

Special Dietary Needs:

Celebrating a Special Occasion?:

Who were you refered by?:

SELECT YOUR TOUR

CRUISE ACCOMMODATIONS
If you're joining in one of our cruises please select your accommodations below.

SELECT METHOD OF PAYMENT

Please make payable to: ScrapMap

Mail to:
ScrapMap
117 West Saint Paul Street
Spring Valley, IL 61362

Payment will be required upon confirmation of booking, confirmation of booking is required within one week of reservation submission, please read our terms and conditions before proceeding.

Comments:

All parties represented in this reservation acknowledge that they have read and agree to all terms and conditions. *
The information submitted on this form will be used for booking purposes and if there are any changes at a later date it could result in a minimum $150 change fee.

I authorize Sew Many Places to automatically charge my card for scheduled payments.
I would be interested in receiving a quote for trip insurance.

				Friday, May 24, 2013

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