Nice, Florence & Rome - Booking Form
Please complete the form below to submit your registration. We will review your submissions and contact you if we have questions. We will send you an invoice via PayPal on or about Oct. 15, 2018 for 50% of the tour price, along with Terms & Conditions which you will be asked to thoroughly read, sign and return. You may pay the invoice via credit card.
Title *
Mr., Mrs, Ms, etc.
Your answer
Name as it appears on your Passport *
Your answer
Email address *
Your answer
Mobile phone *
Your answer
Address - line 1 *
Your answer
Address - line 2
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Date of Birth (required for train tickets) *
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Emergency Contact name - someone we should call back home if you become ill while traveling? *
Your answer
Emergency contact phone number *
Your answer
Date your Passport Expires? *
We recommend you have at least 12 months validity remaining on your passport for international travel.
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What is the name of your roommate, if you have one? *
Your answer
Flight Information
Date of Arrival in Nice *
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Arrival time of your flight to Nice *
Time
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Airline & Flight number *
Your answer
Are you staying for Nice only, Nice & Florence, or Nice, Florence & Rome? We need to know how, when and from where you plan to depart the tour (not everyone is staying the full 12 nights). *
Your answer
Date of departure from the Tour *
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Time your flight departs Europe
Time
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Airline & flight number
Your answer
Please list any chronic medical conditions of which we should be aware (these will be kept confidential). If you would like to leave a doctor's name and phone number we should contact on your behalf if you fall ill on the trip, please do so. Otherwise we will use your emergency contact you listed above. Please check your health insurance policy so you know in advance what coverage you have while traveling abroad. Most US policies require you to pay for care abroad, and they might reimburse you afterwards. We strongly recommend you purchase travel insurance with broad protection that includes medical coverage, as well as reimbursement for trip expenses. It is your responsibility to shop, compare and purchase insurance. Two popular companies are Travelex and TravelGuard.
Your answer
This is an active walking trip. Are you able to walk up to 2 miles a day (with rest stops) and ascend/descend two flights of stairs? *
Is there any other information you would like us to know about your participation?
Your answer
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