15 DAY GERMAN WHITE  CHRISTMAS & NEW YEARS BERLIN TOUR 
Contact Details
Title *
First name (as per passport) *
Please enter exactly as per your passport
Your answer
Middle name (as per passport)
Please enter exactly as per your passport (leave blank if you have no middle name)
Your answer
Family name (as per passport) *
Please enter exactly as per your passport
Your answer
Date of birth *
MM
/
DD
/
YYYY
Street Address *
Your answer
Suburb *
Your answer
State *
Postcode *
Your answer
What is your Postal address if different to your street address?
Your answer
Mobile Phone *
Your answer
Overseas Contact Number if different to your mobile phone
Your answer
Home Phone
Your answer
Work Phone
Your answer
Personal Email Address *
Your answer
Work Email Address
Your answer
Passport Details
Full passport details are required prior to departure to complete your international booking. If you do not have your passport details handy, please leave blank and send through your information at your earliest convenience.
Passport Number
Your answer
Nationality
Your answer
Place of Birth
Your answer
Place of Issue
Your answer
Passport Issue Date
MM
/
DD
/
YYYY
I am a single traveller.
Untitled Title
Minimum Mobility Requirements
The need to walk. Our tours visit a variety of hilltop towns, castles, and attractions with steep staircases and no lifts. In some larger cities coach passenger drop off points may be 15 minutes or so walk from the town centre. Passengers must be able to embark and disembark coaches and boats without assistance. Therefore, these tours may not be suitable for people with mobility issues. If unsure please call our office for further clarification.
Do you have any medical conditions, mobility issues or physical limitations we should be made aware of? * *
What is the maximum distance you are able to comfortably walk? * *
Do you walk with the assistance of a cane or walker or use a wheelchair? *
Travel Insurance Information
Please note: It is a condition of travel that each passenger has comprehensive travel cover.
Travel Insurance Company
Your answer
Policy Number
Your answer
24 Hour Assist Company Name
Your answer
Passport Expiry Date
MM
/
DD
/
YYYY
Additional Flight Requirements
Please note that these are requests only and are not confirmed.
Seating preference
Special meal requirements
Any other special requests or information that I should know?
Your answer
Your favourite drink....red/white/bubbles?
Your answer
Emergency Contact
Please advise contact details below of someone we can contact if required in case of an emergency. In doing so, you give us permission to disclose information regarding your booking details to this person if required.
Full Name
Your answer
Relationship
Your answer
Mobile Phone
Your answer
Email
Your answer
Address
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of TravelManagers. Report Abuse - Terms of Service - Additional Terms