800-683-7731
Please review the Tour Reservation Form, scroll to the bottom of each page and individually print all 6 pages. Return the 6 completed pages to Palace Travel.
TOUR RESERVATION FORM
Carefully read the Terms and Conditions listed on our website at
http://www.palacetravel.com/page/terms_and_conditions
Complete the following form and click the SUBMIT button. Print and send us a copy of the completed and signed form together with your payment including photocopies of the front and back of the credit card and of the cardholder's Government issued identification (if paying with credit card).
Tour documents will not be issued and travelers will not be permitted to participate in a Palace Travel tour if this completed Reservation Form is not received in our office prior to the start of the tour.
TRAVEL INFORMATION:
TOUR NAME: ______________________________
TOUR DATES: _____________________________
BOOKING NUMBER: ________________________
RESERVATION AGENT: _____________________________
ROOM TYPE REQUEST: _____________________________
PLEASE NOTE: Double occupancy implies room with 2 guests sharing a double, queen or king-size bed, as available at time of check in. We cannot guarantee any specific bed type in advance. Twin occupancy implies a room with 2 twin beds. Single supplement applies when you request not to share a room.
PREFERENCES:
Single supplement for the additional cost quoted.
I will share a room with: _________________________
I will share with another participant (Share not guaranteed)
Non-Smoking Smoking
Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com
TRAVELER 1:
NAME: ____________________________________
ADDRESS: _________________________________
CITY: ______________________ STATE: __________
COUNTRY: __________________ ZIP: ___________________
PHONE:
__________________________ ______________________
HOME CELL
EMAIL: _______________________________________
DATE OF BIRTH: _______________________________
PASSPORT NO: _________________________________
COUNTRY OF ISSUE: ___________________________
ISSUE DATE: ___________ EXPIRATION DATE: _________
EMERGENCY CONTACT: __________________________
CONTACT PHONE: _____________________________
RELATIONSHIP: ________________________________
Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com
TRAVELER 2:
NAME: ______________________________________
ADDRESS: ___________________________________
CITY: ______________________ STATE: ________
COUNTRY: __________________ ZIP: _____________
PHONE:
__________________________ ___________________
HOME CELL
EMAIL: _______________________________________
DATE OF BIRTH: _______________________________
PASSPORT NO: _________________________________
COUNTRY OF ISSUE: ____________________________
ISSUE DATE: ___________ EXPIRATION DATE: ________
EMERGENCY CONTACT: ___________________________
CONTACT PHONE: _____________________________
RELATIONSHIP: ________________________________
Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com
Method of Payment: Check Credit Card Wire Transfer (Contact us for bank details)
AMOUNT $ ______________
IF PAYING BY CREDIT CARD PLEASE PROVIDE THE FOLLOWING INFORMATION
Attach photocopies of the front and back of the credit card and of the card holder's Government issued identification. A 4% handling fee applies to each credit card payment.
CHECK CARDS & DEBIT CARDS NOT ACCEPTED
CREDIT CARD AUTHORIZATION:
CARD HOLDER'S NAME: _____________________________
BILLING ADDRESS: ________________________________
City_____________________ State_______ Zip__________
CARD TYPE: __________________
CREDIT CARD #: ______________________
EXPIRATION DATE: ________________________
CVV #: _____________
THE CVV IS THE LAST 3 DIGITS ON THE BACK OF A MASTERCARD, VISA, AND DISCOVER CARD OR THE UPPER 4 DIGITS ON THE FRONT OF AN AMERICAN EXPRESS
AMOUNT DUE: ______________
4% HANDLING FEE: __________
TOTAL: ____________________
I, the undersigned (print name) ____________________________authorize PALACE TRAVEL, INC to charge my credit card as follows for my and/or my companion's scheduled trip.
SIGNATURE: ____________________________________
Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com
IF PAYING BY CHECK Please make check payable to PALACE TRAVEL, INC. and return this completed form to: 5301 Chestnut Street, Philadelphia, PA 19139, U.S.A.
* FINAL PAYMENT IS DUE AT LEAST 60 DAYS BEFORE THE TOUR STARTS
TRAVEL INSURANCE ACCEPTANCE / WAIVER:
Palace Travel, Inc. recommends that travelers purchase Travel Insurance for the added security and coverage it provides. Palace Travel, Inc. cannot be responsible for cancellation, emergency evacuation, accidents, illness, lost luggage, or flight mishaps, and thus highly suggests that you purchase travel insurance.
Indicate whether you have purchased or have declined Travel Insurance
If you wish to purchase Travel Insurance please visit
http://travelinsurance.palacetravel.com
I _________________decline the purchase of travel insurance
Traveler's Name
______________________
Signature
If you already have Travel Insurance, please provide your policy name and number below.
POLICY NAME: _____________________________
POLICY NUMBER: ___________________________
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Travel Insurance Includes:
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Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com
Complete, sign and mail or fax to Palace Travel, Inc. with first payment. Provide names as they appear on passport at the time of reservation. Palace Travel will NOT be responsible for any consequences due to errors as a result of incorrect names or content provided on this form. Name changes may result in increased costs. Any action or inaction taken by an airline or other carrier is entirely beyond the control of Palace Travel. Name changes on air reservations are subject to penalties imposed by the airline(s).
Final documents will not be issued if the reservation forms are not received by Palace Travel. A signed reservation form is acceptance of the tour program, rate confirmed and constitutes acceptance of the entire Terms and Conditions.
Please be sure that the information you have entered is correct.
FAX: 215.471.8898
Please make check payable to: PALACE TRAVEL, INC.
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Return completed forms and payment to: |
* FINAL PAYMENT IS DUE AT LEAST 60 DAYS BEFORE THE TOUR STARTS
Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com
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