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Future Cruises!

2011 Summer Cruise: Mediterranean

Your Design Team:

Lorri Birmingham

Marilyn Vredevelt

Stoney Creek Collection

2009 Cruise Form: 7 Nights - Alaska

Passenger Information:
Passenger #1 Please print name exactly as it appears on your passport. *=Required Fields.

Prefix

*First Name

Initial

*Last Name

*Date of Birth

*Address1:
Address2:
*City:	State: Zip:
e-mail:

Phone numbers where you can be reached (Format NNN-NNN-NNNN):

*Home: Work: Cell:

Passenger #2 (Each passenger must fill out a separate form. This is for room arrangements only.)

Prefix

First Name

Initial

Last Name

Cabin Accommodations/Dining Arrangements

Please Reserve the Following:

*Suite /Stateroom

*Dining Selection

*Please arrange my cabin accommodations in:

Twin Configuration

Queen Configuration

*Special Needs and Requests: To better serve you can you please provide any dietary restrictions, mobility access requirements or medical conditions. if none, please type "none".

If possible, I would like to be near:

If possible, I would like to dine with:

I am traveling alone and would like to room with another stitcher. Please contact me for pairing arrangements.

Stitching Classes

I will be taking the stitching classes. Classes are $325.00 for 3 classes

Thank you, but I will NOT be taking the stitching classes.

Travel Insurance

For your protection and to ensure the full benefits of your trip planning, TravelSafe Vacation Insurance is available to you for Trip Cancellation, Trip Interruption, Trip Delay, Accident and Sickness, Medical Expenses, Emergency Medical Evacuation, Lost Baggage, Baggage Delay, and more. Please note that insurance is non-refundable.

	I wish to purchase TravelSafe vacation insurance based on the Travel Insurance table shown below.
	I am not interested in Travel Insurance and I acknowledge that I have been offered but choose to decline coverage.

TravelSafe Vacation Insurance:

Cost of Trip	Up to Age 35	Age 36-50	Age 51-62	Age 63-72	Age 73-79	Age 80 and over
$1001-$1500	$45	$56	$85	$113	$158	$188
$1501-$2000	$62	$79	$118	$158	$215	$258
$2001-$2500	$79	$102	$152	$203	$271	$328

Please enter the amount from the Table above, or enter Zero:
If you decline Insurance coverage, please type the word Decline here:

Cruise History

Current Cruise	Past Cruises (Please enter other years you have cruised, separated by commas.)

Initials

By placing my initials in the box to the left, I agree that all information provided above is accurate to the best of my knowledge. Furthermore, my selection for travel insurance is my own choice, and should I elect not to purchase travel insurance, I understand that if I should need to cancel my reservation after the final payment date, I will not receive a refund, and I will hold Serenity NOW Cruise Planners harmless.

Payment Information:

$500 deposit is due upon signing.
Final payment due 6/02/2009 for all cabins.
Deposits are fully refundable prior to the final payment date.
After form submission, we will contact you by phone for payment info.
For Cruise payment Princess Cruise Line accepts MC/VISA/AMEX/Discover.
For Class payment which is do upon signing Stitching Cruise LLC accepts only personal checks.

Please scroll up and verify all information for accuracy, then press the "Submit" Button.

Forms:

Future Cruises!

2009 Cruise Form: 7 Nights - Alaska