RESERVE NOW!

The 2007 Great Belgian Beer Tour

& Ultimate Pub Crawl reservation form

 Please complete and fax to Ciao! Travel at  (619) 297-8114

Tour 1: Amsterdam & Brussels [  ]    Tour 2: Brussels & Prague [  ]    Tour 3: A'dam, Brussels & Prague [  ]

Mr. Mrs. Ms. Dr.__________________________________________________________________

                                   Last Name                   First Name                   Middle

T-Shirt Size: Small [  ]   Medium [  ]   Large [  ]   XL [  ]  XXL [  ]

                                                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

T-Shirt Size: Small [  ]   Medium [  ]   Large [  ]   XL [  ]  XXL [  ]

                                                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: _____________________________ 

[   ]  Please contact me regarding extending my tour itinerary to: ______________________________

 TOUR PRICE ___________ X  Number of Persons ___ =  TOTAL ____________

A deposit of  $500 per person or payment in full* is due with this form.

[   ] ENCLOSED PLEASE FIND MY CHECK  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.

GBBT Tours are offered subject to the terms and conditions as published herein.       CST-2010054-40