Group_______________        Ship_________________        Sailing Date______________
Legal Names (same as Passport or Birth Cert. and ID)        Birthday ( MM/DD/YY )
___    _____________________________________        ________________________
___    _____________________________________        ________________________
___    _____________________________________        ________________________
___    _____________________________________        ________________________
(Please fill out one form per cabin, and please note if needing adjacent cabins)
Address______________________________        Phone Number_________________
_____________________________________        Email_________________________
_____________________________________        Cabin Category_________________
Please send me information on Travel Insurance        YES_____        NO_____
(If insurance is declined passengers should be aware of cancellation penalties as listed in the 
brochure, or online, and agree to abide by them)
Special Needs or Requests__________________________________________________
Credit Card Number_________________________________        Exp______________
Name on Credit Card________________________________
Signature__________________________________________
(no signature required if sending via email)
Cruise Total__________      Amount being Paid__________      Today’s Date_________
(when making a payment for your cruise please email or fax me a new form per payment)
Feel free to contact me at 888-218-3378 ext. 101 or brook@cruisingweddings.com
Cruising Weddings
7831 Sycamore Dr
New Port Richey FL 34654
866-836-8101 Fax
Brook Wilke
Travel Consultant