Italy's Treasures Form

Please fill out and return

	TOUR: Italy's Treasures Art, Food & Wine of Italy	DEPARTURE DATE: Oct 20, 2018
	GROUP NAME: Lifestyle Tours	BOOKING NUMBER: 822314

Available Prepaid Options

Personalize your tour by adding an optional activity below. Our recommended options have been carefully chosen to help enhance your individual experience. Complete the provided Prepaid Options Form to reserve your options. Availability is limited and reservations are on a first come, first served basis. Payment must be received no later than 15 days prior to departure. Prices are subject to change. Children under the age of 18 MUST be accompanied by an adult.

PASSENGERS NAME: (Please submit a separate form for each passenger) Salutation:____ First:___________________ Middle:_________________ Last:______________________ Suffix:____ Nickname:_____________ (Mr., Mrs., Rev.) ( Please print EXACTLY as it appears on Passport) (Jr., Sr.)

		Option	Price Per Person (USD)
		Venetian Serenaded Gondola Cruise • Tuesday, October 30th, 2018 This option operates weather permitting.	75.00
		Lake Maggiore Cruise • Monday, October 22nd, 2018 This option must be purchased at least 20 days prior to the tour’s departure. In the event that the option does not meet the minimum number of guests required to operate, guests who purchased the option will be refunded.	65.00

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	travel date: 10/20/2018 territory: M6	Italy's Treasures Art, Food & Wine of Italy
	RES#: 822314
For Reservations Contact: Tracy Wilson (812) 682-4477 email: tracylifestyletours@gmail.com Lifestyle Tours, 700 State Route 269, New Harmony, IN 47631-9517

A deposit of $500 per person is due upon reservation. If you purchase our Travel Protection Plan, the deposit is only $250 per person plus the cost of the Insurance. A second deposit of $1650 is due by March 14, 2018. Reservations are made on a first come, first served basis. Reservations made after the deposit due date of March 14, 2018 are based upon availability. Final payment due by August 22, 2018. Deposits are refundable up until March 21, 2018.

YOUR INFORMATION:

Clearly print your full name (first/middle/last) as it appears on your government issued travel documentation. A valid Passport is required for trips outside the USA. We strongly recommend that you have a valid passport (with six month validity) for all travel outside the United States.

IMPORTANT: In order to avoid any unnecessary change fees, it is imperative that all guest names are entered correctly from the start. The information below must be the legal name and be 100% identical to the ID being used to travel <passport/driver’s license> including middle names or suffixes <Jr, Sr>.

First: Middle or Initial: Last: Suffix:

Nickname: Gender: ( ) Male ( ) Female Date of Birth: month day year

Address: City: State: Zip Code:

Phone: ( ) Cell: ( ) Email Address:

Passport Number: Expiration Date: (month/day/year) Date of Issuance: (month/day/year)

City, State, Country of Issuance: Citizenship:

Should you become ill or injured, whom should we contact (not traveling with you): Phone: ( )

ROOMING WITH: £ Check if address is the same as Passenger #1

First: Middle: Last: Suffix:

AIR GATEWAY: Departure airport for this tour:

Air Seat Request: ( ) Aisle ( ) Window ( ) Next To Traveling Companion

Collette cannot guarantee your seat preference. If you have not purchased air through Collette and wish to purchase transfers, you must transfer at our pre-scheduled times.

Please be advised, when travelling as part of a group, many airlines do not provide seat assignments. Preferred seating may be available for an additional charge. “Federal law forbids carriage of hazardous materials such as aerosols, fireworks, lithium batteries & flammable liquids aboard the aircraft in your checked or carry-on baggage. A violation can result in 5 years’ imprisonment and penalties of $250,000 or more. Details on prohibited items may be found on TSA’s “prohibited items” web page: http://www.tsa.gov/traveler-information/prohibited-items.”

Travel protection: ( ) Yes, I wish to purchase travel protection $290 ( ) No, I decline

If you choose not to purchase Collette's Waiver Insurance Plan, you will incur penalties for changes and cancellations. Travel Protection Payment is due with first deposit. The Waiver Fee does not cover any single supplement charges which arise from an individual’s traveling companion electing to cancel for any reason prior to departure. The single supplement will be deducted from the refund of the person who cancels. (There is coverage under Part B which includes a single supplement benefit of $1,000 for certain covered reasons. See Part B for details.)

ON TOUR ACTIVITIES: Please choose one of the following on tour activities

( ) Walking Tour of Lucca( ) Bicycle Tour of Lucca

PLEASE MAKE CHECKS PAYABLE TO: Lifestyle Tours ( ) Check ( ) Credit Card

Waiver/Insurance Amount: $___________________ Deposit Amount: $___________________ Total amount enclosed: $___________________

Cardholder Name (if paying by Credit Card):

Cardholder Billing Address: £ Check if address is the same as above

Cardholder Phone: Amount: $

Credit Card Number: ________________ Expiration Date:____

MMYY

Signature Required for acceptance of the below conditions and agreement to credit card use:

Date:

I agree to pay according to the card issuer agreement. I understand and accept the cancellation policy, terms and conditions. See http://www.gocollette.com/about-collette/terms-and... for full terms and conditions of your purchase.

Important Conditions: Your price is subject to increase prior to the time you make full payment. Your price is not subject to increase after you make full payment, except for charges resulting from increases in government-imposed taxes or fees.

ARE YOU A MEMBER OF THE EVANSVILLE MUSEUM OF ARTS, HISTORY & SCIENCE?: ___YES ___NO

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162 Middle Street Pawtucket, RI • 02860 Phone: 1-800-852-5655 Fax: 1-401-727-9014

¨ Above credit card information has been called in to Collette.