EmailMe Form - NIKKI'S DOUBLE NICKLE BIRTHDAY TRIP

GUEST RESERVATION FORM
PLEASE SELECT YOUR ACCOMMODATIONS AND COMPLETE THE GUEST INFORMATION.
NOTE: (Pricing and promotions are subject to change without notice.)
H10 Palazzo Galla - Location: Rome, Italy (2 People): Deposit: $100 per room

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Junior Suite Corner - Free WiFi - $598.82

Superior Venezia - Free WiFi - $452.43

Suite, Balcony - Free WiFi - $718.57
Hyatt Centric Venice Murano - Location Venice, Italy (2 People): Deposit: $100 per room

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King Bed - Bed and Breakfast - $548.24

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Junior Suite Corner - Free WiFi - $598.82
Superior Venezia - Free WiFi - $452.43
Suite, Balcony - Free WiFi - $718.57

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King Bed - Bed and Breakfast - $548.24

CRUISE STATEROOM - 2 People: Deposit $900 per stateroom

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C1 - Prime Concierge Class - 5,061.46
C2 - Concierge Class - $4,960.46
V1 - Prime Veranda - $4,860.46
V2 - Veranda - $4,760.46
O1 - Prime Oceanview - $3,233.46
O2 - Ocean View - $3,133.46

Transfer: VENICE CITY CENTER DROP OFF, VENICE CITY CENTER WHERE, BUSES, CARS, TAXIS AND WATER TAXIS ARE AVAILABLE

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Guest 1: Transfer from cruise port to Venice by bus: $58

Guest 2: Transfer from cruise port to Venice by bus: $58
GUEST 1 *
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PASSPORT INFORMATION

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GUEST 2
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Date of Birth
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PASSPORT INFORMATION

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Known Traveler Number:
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Cardholder's Authorization
I have been informed of the supplier’s cancellation policies for travel services and agree to the supplier’s terms and conditions. I have been informed of the benefits of travel protection and understand if purchased, the premium is non-refundable.
At this time I have decided to purchase travel insurance.
Accept
Decline
I understand Debit Cards often impose "Daily Charge Limits" and multiple payments may be needed to complete the full balance due. I am aware of any potential Cancellation, Refund and Surcharge Policies and Fees by suppliers and agree not to dispute or chargeback any of the below signed for and acknowledged charges without proper course of action. I understand that Zandra Black with BAPS Travel will impose the following charges when contractually applicable: all non-insured reservations are subject to Cancellation Fees per traveler and will be applied to the provided credit card account. Zandra Black with BAPS Travel will not release personal information to ANY parties not listed on your finalized Travel Quote and will apply due diligence in maintaining records in a secure, safe location.
Electronic Signature Consent I consent to provide an electronic signature rather than a handwritten signature in connection with my Credit Card authorization. I submit my signature by typing my name below and checking the “I agree” box. I understand that my electronic signatures will be binding as though I had physically signed this document by hand. I agree that a printout of this authorization may be accepted with the same authority as the original.
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Guest 1: Transfer from cruise port to Venice by bus: $58
Guest 2: Transfer from cruise port to Venice by bus: $58


Passport Number:
Passport Expiration:
Country/Region of Issuance:
Country/Region of Residence:
Known Traveler Number: