Hahn Cruise - April 2011

Email address for receipts and contact_______________________
Full legal names of passengers and dates of birth:
1st -Name________________________________________
Address: ______________________________________
Dob:__________________________________________
Phone:________________________________________
2nd -Name________________________________________
Address: _______________________________________
Dob:__________________________________________
Phone:________________________________________
If applicable:
3rdName________________________________________
Address: _______________________________________
Dob:__________________________________________
Phone:________________________________________
4th Name________________________________________
Address: _______________________________________
Dob:__________________________________________
Phone:________________________________________
What type of cabin do you want - inside (4b no window) or outside (oceanview window)?
__________________________
Do you want cruise insurance? __________________(if not you will need to complete the decline
insurance form and fax back to me)
Do you want prepaid gratuities (tips)? _____________________(can prepay or pay the $10 per person per
day while on board ship)
Are you celebrating any special occasion on board, bday or anniversary?_____________
Do you have any medical or diet needs such as diabetic, etc?____________________
Have you cruised before?_____________________________
Will you be flying or driving to port of Jacksonville?_______________________

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