Collette Travel Date 06/17/2020 Territory: M8 RES#: 975051 Shades of Ireland
For Reservations Contact: Meg Farber (563)505-9812 Email: ddestinations1@gmail.com
Distinctive Destinations, 3215 E. Locust St. #11, Davenport, IA 52803
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A deposit of $815 per person is due upon reservation. Reservations are made on a first come, first served basis. Reservations made after the deposit due date is based upon availability.
Your Information
Clearly print your full name (first/middle/last) as it appears on your government issued travel documentation.
Important: In order to avoid any unnecessary change fees, it is imperative that all guests name are entered correctly from the start. The information below must be the legal name and be 100% identical to the ID being used to travel <passport/driver’s license> including middle names or suffixes <Jr, Sr>.
First: ___________________________ Middle: ___________________________ Last: ___________________________ Suffix: _________________________
Nickname: ________________________ Gender: ( ) Male ( ) Female Date of Birth: Month __________ day __________ Year _________
Address: ___________________________________________ City: __________________________________ State: ________ Zip Code: _______________
Phone: ( ) _______________________________ Cell: _____________________________ Email Adrress: _____________________________________
Passport Number: _________________ Expiration Date: (MM/DD/YYYY) ____________ Date of Issuance: (MM/DD/YYYY_________________
City, State, Country of Issuance: ____________________________________________________ Citizenship: __________________________________
Should you become ill or injured, whom should we contact (not traveling with you): _____________________ Phone: ( ) ___________
ROOMING WITH: ( ) Check if address is the same as Passenger #1.
First: ________________________________ Middle: ___________________________ Last: __________________________ Phone ( ) ________________
Air Gateway: Departure airport for this tour: _______________________________
Air Seat Request: ( ) Aisle ( ) Window ( ) Next To Traveling Companion
Collette cannot guarantee your see preference. If you have not purchased air through Collette and wish to purchase transfers, you must transfer at our pre-scheduled times. Please be advised, when traveling as part of a group, many airlines do not provide seat assignments. Preferred seating may be available for an additional charge. Please reserve an upgrade to Elite Airfare for an additional rate of: ( ) Business Class $3,990.
Service is limited and not available on all flights or carriers. Other restrictions may apply. Please note: if you purchase an upgrade we cannot guarantee the same flight schedule as the group. If Business class service has been purchased, it is for the international portion of the journey only. Are you willing to separate from the group air schedule to accommodate your upgrade request: ( ) Yes ( ) No.
“Federal law forbids carriage of jazardous materials such as aerosis, fireworks, lithium batteries & flammable liquids aboard the aircraft in your checked or carry-on baggage. A violation can result in 5 years imprisonment and penalties of $250,000 or more. Details on prohibited items may be found on TSA’s “prohibited items” web page http://www/tsa/gov/traveler-informational/prohibited-items.”
Travel Protection: ( ) Yes, I wish to purchase travel protection $315 ( ) No, I decline.
If you choose not to purchase Collette’s Waiver Insurance Plan, you will incur penalties for changes and cancellations. Travel Protection Payment is due with first deposit. The waiver Fee does not cover any singe supplement charges which arise from an individuals companion electing to cancel for any reason prior to departure. The single supplement will be deducted from the refund of the person who cancels. (There is coverage under Part B which includes a single supplement benefit of $1,000 for certain covered reasons. (See Part B for details.)
ON TOUR ACTIVITIES:
Please choose one: Please choose one:
( ) Dublin City Tour by bus ( ) House of Waterford Crystal
( ) Dublin City walking tour ( ) Waterford Medieval Museum and Wine Vault
PLEASE MAKE CHECKS PAYABLE TO: Collette ( ) Check ( ) Credit Card
Waiver/Insurance Amount: $_______________ Deposit Amount: $ ______________ Total amount enclosed: $ _____________________
Cardholder Name (If paying by Credit Card): _____________________________________________________________________________________
Cardholder Billing Address: ( ) Check if address is the same as above _________________________________________________________
Cardholder Phone: ______________________________________________________________ Amount: $ _____________________________________
Credit Card Number: _______________________________________________ Expiration Date: __________ (MM/YYYY)
Signature Required for acceptance of the below conditions and agreement to credit card use.
_________________________________________________________________________________ Date: ___________________________________________
I agree to pay according to the card issuer agreement. I understand and accept the cancellation policy, terms and conditions. See http:/www.gocollette.com/aboutcollette/terms-and-conditions for full terms and conditions of your purchase.
Important Conditions: Your price is subject to increase prior to the time you make full payment. Your price is not subject to increase after you make full payment, except for charges resulting from increases in government taxes or fees.