TRAVELERS' DETAILS AND CREDIT CARD AUTHORIZATION TRAVELERS MUST HAVE PROPER TRAVEL DOCUMENTS For international travel, excluding cruises that begin at and return to the same U.S. port, U.S. CITIZENS MUST HAVE A VALID PASSPORT.For cruises that begin at and return to the same U.S. port, U.S. CITIZENS must have a VALID PASSPORT or original certified birth certificate w/raised seal and photo ID. NON-U.S. CITIZENS and RESIDENT ALIENS should contact their respective embassies and U.S. Immigration for applicable regulations. ONLY ONE REGISTRATION FORM PER TRIP ITINERARY Traveler one Gender ---Please Select--- male female other U.S. citizen ---Please Select--- yes no Date of Birth ADD ADDITIONAL TRAVELER Six-Month Passport Validity Rule *Passport must be valid for a minimum of 6 months post the start of your trip. If anyone attending this proposed trip have a passport expiring less than six months after the desired travel dates, please renew your passport !* Deposit Requirements We strongly recommend purchasing travel insurance due to the vendor's very strict cancellation policies. This is to confirm that you are aware of the cancellation penalties as described above on this page and that travel insurance is available for purchase to protect against cancellation penalties due to unforeseen MEDICAL reasons. DO YOU UNDERSTAND THE SIX-MONTH PASSPORT RULE? ---Please Select--- Yes No DO YOU UNDERSTAND YOUR TRAVEL INSURANCE OPTIONS? ---Please Select--- Yes No DO YOU WISH TO PURCHASE TRAVEL CANCELLATION INSURANCE? ---Please Select--- Yes No BILLING & TICKETING INFORMATION (P.O. Boxes Not Accepted) Card Type VISA MC AMEX DISCOVER Expiration Date Month January February March April May June July August September October November December (+)add another card ADDITIONAL INFORMATION OR SPECIAL REQUEST Time to Split 973.804.9115 tslegros@timetosplit.org