EmailMe Form - Samy Travel Customer Information

Do you have a specific sailing that you are interested in? Please list the date you want to sail or the specific ports that you would like to visit.

Who referred you to Samy Travel LLC? Please list their name so that we can reward them.

Which Cabin category would you like ? *

Is there a specific area of the ship you would like for your cabin to be

i.e specific deck(Upper, Main, Empress, Lido, Panaroma, Verandah)

Specific area( Aft - back, Middle, Front)

Specific side ( Port - left, Starboard - right)

Would you like to pre-pay gratuities?

Please note that if you do not prepay gratuities, they will be added to your final bill on the cruise. *

Please choose a dining option *

Would you like a travel insurance quote? *

I decline Travel Insurance

Please add Cruise line insurance

Please quote Allianz Insurance

Do you have any special requests that require assistance from the cruise line?

Please let us know as soon as possible and no later than 3 weeks before your sail date if you will assistance. *

________________________________________________________________________________________

#1 Passenger Full Name *

Prefix First Middle Last

#1 Date Of Birth *

MM / DD / YYYY

Phone *

### - ### - ####

Email *

Have you ever cruised before? *

Cruise line loyalty number, if applicable

Address *

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

__________________________________________________________________________________

#2 Passenger Full Name

Prefix First Middle Last

#2 Date of Birth

MM / DD / YYYY

Phone

### - ### - ####

Email

Have you ever cruised before?

Cruise loyalty number, if applicable

Address

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

_________________________________________________________________________

#3 Passenger Name

Prefix First Middle Last Suffix

#3 Passenger Date of Birth

MM / DD / YYYY

Email

Have you ever cruised before?

Cruise loyalty number, if applicable

Address

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

_______________________________________________________________________________________

#4 Passenger Name

Prefix First Middle Last Suffix

#4 Passenger Birthdate

MM / DD / YYYY

Country of Residency

Email

Have you ever cruised before? *

Cruise line loyalty number, if applicable

Address

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

We do not need to know if you have a criminal history, BUT it is important that you understand any travel restrictions based on your criminal history. International travel, including cruises, will require an immigrations check that may not allow you to travel if you were convicted of a felony, have back child support, a DUI or other legal issues. If you are on parole, you must have permission from your parole officer to travel. If you have finished your sentence, even if it was many years ago, we urge you to visit Travel.State.Gov and check for any restrictions to your destination. Some destinations have more strict rules than others. By submitting this form, you accept responsibility and absolve Samy Travel of any responsibility if you are denied travel due to criminal history OR lack of proper documentation. Not checking this box will invalidate this form and no travel arrangements will be made. * *

I agree and understand

I understand that it is my responsibility to have proper travel documentation for the destinations I am traveling to. If I have questions about my travel documentation, I will refer to www.travel.state.gov and will ask questions of my travel agent well in advance of travel. Samy Travel nor the agent, nor the tour operator in which I book my trip through are responsible for ensuring that I have proper travel documentation. *

I agree and understand