Lead Guest Title
*
Mr.
Mrs.
Ms.
Miss.
Mstr.
Dr.
Other
Lead Guest Full Name - (Name must be written EXACTLY as it appears on passport including middle name(s) and/or initials)
Email Address
*
Lead Guest Passport Number - (If you don’t currently have your passport or are in the process of renewing it, please let your agent know.)
Lead Guest Nationality
Lead Guest Date of Birth
MM
DD
YYYY
Lead Guest Place of Birth
Lead Guest Passport Date of Issue
MM
DD
YYYY
Lead Guest Passport Date of Expiration
MM
DD
YYYY
Guest #2 Title
Mr.
Mrs.
Ms.
Miss.
Mstr.
Dr.
Other
Guest #2 Full Name - (Name must be written EXACTLY as it appears on passport including middle name(s) and/or initials)
Guest #2 Passport Number - (If guest doesn’t currently have their passport or are in the process of renewing it, please let your agent know.)
Guest #2 Nationality
Guest #2 Date of Birth
MM
DD
YYYY
Guest #2 Place of Birth
Guest #2 Passport Date of Issue
MM
DD
YYYY
Guest #2 Passport Date of Expiration
MM
DD
YYYY
Guest #3 Title
Mr.
Mrs.
Ms.
Miss.
Mstr.
Dr.
Other
Guest #3 Full Name - (Name must be written EXACTLY as it appears on passport including middle name(s) and/or initials)
Guest #3 Passport Number - (If guest doesn’t currently have their passport or are in the process of renewing it, please let your agent know.)
Guest #3 Nationality
Guest #3 Date of Birth
MM
DD
YYYY
Guest #3 Place of Birth
Guest #3 Passport Date of Issue
MM
DD
YYYY
Guest #3 Passport Date of Expiration
MM
DD
YYYY
Guest #4 Title
Mr.
Mrs.
Ms.
Miss
Mstr.
Dr.
Other
Guest #4 Full Name - (Name must be written EXACTLY as it appears on passport including middle name(s) and/or initials)
Guest #4 Passport Number - (If guest doesn’t currently have their passport or are in the process of renewing it, please let your agent know.)
Guest #4 Nationality
Guest #4 Date of Birth
MM
DD
YYYY
Guest #4 Place of Birth
Guest #4 Passport Date of Issue
MM
DD
YYYY
Guest #4 Passport Date of Expiration
MM
DD
YYYY
More than four travelers in your party?
Please list any additional travelers in your party, including titles, first, middle & last names, passport numbers, nationality, date of birth, place of birth, date of issue and date of expiration. For any children without a passport, please include their title, first, middle and last name, nationality and date of birth.
Destination (s)
*
Vacation Start Date
*
When are you leaving for your adventure?
MM
DD
YYYY
Credit Card Type
*
Visa
Disney Visa
Mastercard
American Express
Discover
Other
Credit Card Number
*
Expiration Date
*
Billing Name
*
Exactly as it appears on the credit card.
First Name
Last Name
Billing Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Billing Phone
*
(###)
###
####
Shipping Address Same as Billing Address
Are you celebrating anything on this trip? An anniversary, birthday, milestone etc?
Shipping Address (If different from Billing Address)
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Notes
Anything else I should know?
Client Agreement
*
When you retain People Mover Travel to help plan your travel, you're hiring a professional travel advisor to ensure that your trip is tailored to your taste, preferences, and budget. You get the benefit of our skill, experience and training, our professional relationships, and our industry connections.
By checking the box below, and submitting this form, you acknowledge that you are hiring us to plan your trip, and that you have read and agree to our
Terms & Conditions of booking.
Travel Insurance Acknowledgement
*
Emergencies can happen when you least expect them. People Mover Travel highly recommends that all clients purchase a travel insurance policy to protect their investment in their travel. Cruise lines, airlines, hotels, and tour operators all charge high penalties for cancellation, ranging from the full deposit to no refund at all. And, keep in mind that most health insurance policies will not cover you when you are out of the country. Travel insurance can protect you in the event of Trip Cancellation, Trip Delay, Trip Interruption, Missed Connection, Baggage Loss, Theft or Damage, Baggage Delay, Emergency Medical and Dental Expenses, and Emergency Medical Transportation, among other unforeseen circumstances.
Please also note that in order for you to obtain coverage for certain pre-existing conditions, or for supplier default, your policy must be purchased at the time of booking or shortly thereafter (depending on the terms of the policy).
Please understand that we are not registered insurance agents, and cannot legally provide specific advice or information regarding insurance. We will gladly secure a quote for you, upon request, and if People Mover Travel does not, or is not legally able to secure coverage on your behalf, it is our strong recommendation that you purchase a policy on your own.
I acknowledge that People Mover Travel has recommended or offered travel insurance protection to me. Should I choose not to purchase such a policy, I accept all responsibility for declining to secure coverage.
