CIAO! TRAVEL TOUR RESERVATION FORM

PLEASE PRINT THIS PAGE, FILL OUT COMPLETELY AND FAX TO (619) 297 8114

2004 JAZZ EUROPE^tm TOURS

[ ] SMOOTH JAZZ TV MONTREUX WEEKENDER PACKAGES, Switzerland

[ ] 3 NIGHTS [ ] 6 NIGHTS

Mr. Mrs. Ms. Dr.__________________________________________________________________

Last Name First Name Middle

Your name as it appears on your passport

Address: ____________________________City__________________ State___ ZIP_____________

Tour document delivery address-Signature required for delivery

Business/Day Tel__________________________ Home Tel ________________________________

………………………Traveling Companion………………………

Mr. Mrs. Ms. Dr.___________________________________________________________________

Last Name First Name Middle

Your name as it appears on your passport

Address: ____________________________City__________________ State___ ZIP______________

Business/Day Tel __________________________ Home Tel ________________________________

[ ] I/we wish to purchase a COMPLETE tour package, including round trip air transportation.

Please state any special dietary or physical needs for your flights: ________________________________________

[ ] I/we wish to purchase a LAND ONLY tour package, I have made alternate flight arrangements.

Hotel Name or Cabin Category:_________________________ Dates from: __/__/04 to __/__/04

OPTIONAL PREMIUM RESERVED SEATS: (Same number of nights as hotel stay)

Montreux [ ] 3 Nights $199, [ ] 6 Nights: $349, [ ] North Sea All-In Pass 3 nights: $259

TOUR PRICE ___________ X Number of Persons ___ = TOTAL ____________

A deposit of $400 per person or payment in full* is due with this form.

[ ] ENCLOSED PLEASE FIND MY CHECK IN PAYMENT FOR [ ] DEPOSIT or [ ] PAYMENT IN FULL

*( PAYMENT IN FULL GUARANTEES YOUR TOUR PRICE )

[ ] PLEASE CHARGE: [ ] MY DEPOSIT or [ ] PAYMENT IN FULL TO MY:

[ ] AMERICAN EXPRESS, [ ] VISA [ ] MASTER CARD [ ] DISCOVER

Card Number:__________________________________________ Expiration date: ___/___

Name as on Card:__________________________________ Signature:____________________

Credit card billing address;_______________________________________________________

Total Amount Enclosed or Charged:__________________

Insurance: [ ] Please send a cancellation/health trip insurance brochure. Ciao! Travel strongly recommends trip cancellation,

baggage, accident and health insurance to help safeguard your Jazz Europe vacation.

Reservations are subject to the terms and conditions as published in Ciao! Travel’s 2004 Jazz Europe

and Jazz America tour brochure and this website. CST 2010054-4 CT/TRF 03-17-04