Regina Tours Passenger Participation Agreement
494 Eighth Avenue, 22nd Floor * New York, NY 10001-2519
Tel: 440-635-1003 - Fax: 440-635-0858 - 1-800-465-9276
www.regina-tours.com
Please mail this form with your initial $250 deposit to: FrassatiUSA, P.O. Box 50571, Nashville, TN 37205.
Enclosed is deposit of $250.00 per person payable to Regina Tours. Cancellation fees apply as noted in Regina Tours Terms & Conditions.
Insurance is highly recommended at additional cost of ($109 – $279) per person. ______Yes ______No Insurance is non-refundable.
Departure Tax and Fuel Surcharges are additional and subject to change/increase until group is ticketed.
I (we) want to join you on: TOUR NAME: PIER GIORGIO PILGRIMAGE 2009 DEPARTURE DATE : June 26, 2009
□ I (we) would like Regina Tours to make flight arrangements from my (our) home city to the departure city (Nashville, Tennessee.) Price is subject to availability at time of booking and a service fee will be applied to all domestic tickets booked by Regina Tours.
Name of Airport or Home city of departure: ______
(Regina Tours can not accept discount coupons, Frequent Flyer Miles, nor do we offer Senior citizen rates. Travel must be on dates of tour and air carriers used are at discretion of Regina Tours.) Regina Tours assumes no responsibility for Passport, Visa/Document Procurement if required.
□ I (we) will handle our own flight arrangements from home city to the departure city (Nashville, Tennessee.) International carriers recommend arrival into departure city a minimum of 3 hours prior to departure time. Regina Tours is not responsible for flights booked by passengers.
PLEASE REFER TO OUR TERMS AND CONDITIONS FOR ADDITIONAL INFORMATION
NAMES SGL/DBL NAME OF ROOMMATE SEX SPECIAL REQUEST
As appears on passport ROOM If Applicable M/F Meals/Wheelchair/etc.
1.______
2.______
3.______
STREET ADDRESS: ______(Express Delivery Service will not deliver to P.O. Box)
CITY: ______STATE: ______ZIP:______
HOME/CELL PHONE: ______BUSINESS PHONE: ______EMAIL: ______
PRICES: Published prices reflect a discount for purchases made with cash or checks. There are no discounts for sales made by credit card. If you choose to pay by credit card, complete all required information requested in box below. Prices are per person and based upon shared twin room occupancy. In case of human or computer error, Regina Tours reserves the right to re-invoice for the corrected price increase.. A full refund will be made to passengers who choose not to pay an increase, provided Regina Tours receives a written cancellation within five days of the price increase notification.
□ DEPOSIT CREDIT CARD PAYMENT AUTHORIZATION: AMOUNT: $______
□ FULL PAYMENT CREDIT CARD AUTHORIZATION FOR BALANCE DUE: AMOUNT: $______
CREDIT CARD HOLDER NAME: ______
VISA/MASTERCARD/AMEX NUMBER: ______EXP DATE: (MO/YR): ______
SIGNATURE OF CARD HOLDER: ______DATE: ______
EMERGENCY CONTACT: ______RELATIONSHIP: ______
ADDRESS: ______CITY/STATE/ZIP: ______
HOME PHONE: ______BUSINESS PHONE: ______CELL PHONE: ______
Tour prices are based on minimum 30 passenger participation. If group falls below this number, an increase may be necessary to insure tour can operate.
The signatures below indicate that I (we) have read and agree to the Terms and Conditions included in/on this brochure.
SIGNATURES: ALL PASSENGERS MUST SIGN THIS FORM
1. ______DATE: ______
2. ______DATE: ______
3. ______DATE: ______