Make a Memory, Travel®- New Client Booking Registration Form 2020-2021
This form is required for all bookings and indicates the intent to travel. Note that under the new REAL ID Act, a valid passport(s) may be required for all air ticketing. Your payment will not be processed until we contact you to verify your information. For security purposes, do not include any secure information other than what is requested. We strongly discourage the use of debit cards for authorizations; Your funds will be held against your balance until actual travel time.
Should you have any questions, please feel free to contact our office.
Thank you!

Date of Departure *
MM
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DD
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YYYY
Date of Return *
MM
/
DD
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YYYY
Flexible Dates/Length of Stay
Use this space to list alternate dates if you wish- NOT REQUIRED
Your answer
Destination or Group Name *
Include cities, must see attractions, events or any information regarding your destination(s)
Your answer
How many total people in your party, including infants? *
What is your party's rooming preference? *
# of guests in each room. IE) Family of 4- quad =all 4 in 1 room; Double= 2 in each room
SIngle
Double
Triple
Quad (Typically 2 Queens in the US)
Quint (May not be available)
6 or more (May not be available in 1 room)
Check all that apply
Do all your guests have valid passports? *
For air, cruises, & resorts: Please list full names EXACTLY as listed on passports. Dates of birth & age at time of travel for all guests are required.
(FORMAT: Last, First, Middle DOB Age at Time of Travel)
Guest 1- Lead Contact for Your Party, DOB, Age *
Full, Legal Name & Birthdate as on passport or if not flying- drivers license
Your answer
Full MAILING address, for this household *
May be required for document delivery or by suppliers. (Don't forget apartment numbers)
Your answer
Guest 1 Passport Number, Issue Date, Expiration Date
As on passport, typically required for international flights. Copies can be emailed to Makeamemory@yahoo.com.
Your answer
Email Address - Guest 1/Lead Contact *
Your answer
Phone Number to Best Reach You *
Indicate Home or Cell ; you may include more than 1 if needed
Your answer
Guest 2 Name, DOB, Age
As on passport, or if not flying- drivers license; may include secondary contact information such as phone number or email
Your answer
Guest 2 Passport Number, Issue Date, Expiration Date
As on passport, typically required for internatinal flights. Copies can be emailed to Makeamemory@yahoo.com.
Your answer
Guest 3 - Name, DOB, Age
Your answer
Guest 4 - Name, DOB, Age
Your answer
Guest 5 - Name, DOB, Age
Your answer
Guest 6 - Name, DOB, Age
Your answer
Please provide any Frequent Flier, Loyalty #s, Global entry/TSA numbers that may apply. You may also submit them to: makeamemory@yahoo.com
Your answer
PLEASE CONFIRM: Your air will be ticketed exactly as listed above. I understand & accept Make a Memory Travel®, LLC will not be held responsible for any penalty charges, fees, or reimbursement for any ticketing errors or discrepancies. (Check to proceed) *
Required
Any special needs, allergies, dietary restrictions, medical or infant equipment requirements?
Your answer
Any special celebrations or events? Please list:
Your answer
Any special instructions or concerns?
Your answer
Travel Protection- Insurance Waiver
By taking out travel insurance you are essentially covering yourself against travel risks such as lost or stolen luggage, cancellation (should you not be able to travel due to unexpected medical reasons) and most importantly, unexpected medical costs abroad. Providers and plans offer various coverage at different levels. Consult an expert for help or decision making regarding specific plans. We STRONGLY encourage you to purchase travel insurance. If you choose to decline all offered protections, you (the guest) assume any and all personal, mental, and financial losses.
PLEASE CONFIRM: Travel Protection is strongly encouraged to protect your travel investment & family. (Please check one) *
Required
Optional: Beneficiary- Name and Contact Info
Your answer
Emergency Contact: name, relation & phone number of someone NOT traveling with you * *
Your answer
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