EmailMe Form - BARBADOS SPRING BREAK 2025

Name *

First Last

Date of Birth *

MM / DD / YYYY

Please Select Room Choice

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

ROOMMATE NAME *

Credit Card *

Exp *

CVC *

Phone Number *

Email Address *

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 $200 deposit *

Yes

No

DEPARTURE AIRPORT *

SKY MILES #

Please Add Travel Protection to my Deposit *

YES Voucher

YES Refund

NO I DECLINE INSURANCE

Additional Travelers Name and Birthday if paying with the Same Card