EmailMe Form - CARTAGENA GROUP TOUR 2025

Name *

Prefix First Last

Date of Birth *

MM / DD / YYYY

Please Select Room Choice *

	Yes	No
Double Beds
King Bed
Single Occupancy
Window Seat (If Available)
Aisle Seat (If Available)
Food Allergies
I have a valid U.S passport, or will obtain one prior to travel

Credit Card # *

Exp *

CVC *

Phone Number *

Roommate Name *

Email Address *

Departure Airport *

T-SHIRT SIZE *

Emergency Contact Name & Number

Billing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

I authorize Hill Travel Adventures to process my deposit of $100 per person

Yes

No

I understand that remaining deposit of $100 will be due on August 1st, 2024

Yes

No

Travel Protection Insurance *

Please add voucher insurance to my deposit

Please add refund insurance to my deposit

I decline travel protection insurance

Skymiles #

Additional Names and Birthdays of Roomates if Paying with Same Card