*
= Required
09/09/2024 08:34:39 AM
TRAVELER REGISTRATION FORM
Tour:
Departure Date:
11/28/2023
Agency Name:
*
Agent Name:
*
AGENCY IS:
*
Select
New to ETS
Existing Agency with ETS
Agent ID#:
(Leave blank if unknown)
ARC/IATA/CLIA#:
EMAIL:
*
PHONE#:
*
Number of Guests for this Registration:
*
1
2
PASSENGER #1 DETAILS:
Legal Name:
*
(As it appears on passport)
First:
Middle:
Last:
Title:
*
(Mr/Mrs/Ms/Dr/Rev, etc.)
Name Tag:
(If different than above)
Passport Number:
Birth Date:
Month
01
02
03
04
05
06
07
08
09
10
11
12
/
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
(4 digit Year)
Place of Birth:
Place of Issue:
Issue Date:
Month
01
02
03
04
05
06
07
08
09
10
11
12
/
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
(4 digit Year)
Passport Expiration:
Month
01
02
03
04
05
06
07
08
09
10
11
12
/
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
(4 digit Year)
Nationality:
USA
Other (Please specify):
Sex:
*
Male
Female
Basic Tour:
*
Pre-Tour:
Post-Tour:
Domestic Departure City:
Select
Roommate:
*
Select
Single Room (availability limited)
Roommate name is listed below
Please try to match with a Roommate
Roommate Name:
Travel Protection Plan:
*
Click for Details
Accept the Travel Protection
Decline the Travel Protection
Diet/Mobility Request:
(Leave blank if none)
Other Special Request:
(Leave blank if none)
PASSENGER #2 DETAILS:
Legal Name:
*
(As it appears on passport)
First:
Middle:
Last:
Title:
*
(Mr/Mrs/Ms/Dr/Rev, etc.)
Name Tag:
(If different than above)
Passport Number:
Birth Date:
Month
01
02
03
04
05
06
07
08
09
10
11
12
/
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
(4 digit Year)
Place of Birth:
Place of Issue:
Issue Date:
Month
01
02
03
04
05
06
07
08
09
10
11
12
/
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
(4 digit Year)
Passport Expiration:
Month
01
02
03
04
05
06
07
08
09
10
11
12
/
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
(4 digit Year)
Nationality:
USA
Other (Please specify):
Sex:
*
Male
Female
Basic Tour:
*
Pre-Tour:
Post-Tour:
Domestic Departure City:
Select
Roommate:
*
Select
Single Room (availability limited)
Roommate name is listed below
Please try to match with a Roommate
Roommate Name:
Travel Protection Plan:
*
Click for Details
Accept the Travel Protection
Decline the Travel Protection
Diet/Mobility Request:
(Leave blank if none)
Other Special Request:
(Leave blank if none)
PAYMENT
A minimum deposit of
$
0.00
is required for each guest (
0.00
Total)
Form of Payment:
*
Agency Check
Credit Card
Total Minimum Deposit Required:
$
0.00
STATEMENT OF RESPONSIBILITY AND AGREEMENT
*
I have read and understand the tour conditions and cancellation policies listed in the Group Agreement. I also understand that ETS is not responsible to provide necessary travel documents, such as Visas, for non-US citizens. It is my responsibility to check with the consulate for each country visiting and obtain any necessary paperwork required to enter those countries. I understand that all passengers submitted above are subject to confirmation.
I DO NOT understand and agree to the conditions and policies listed in the Group Agreement.
.
All amounts listed are in U.S. Dollars
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