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

 

                      2011 JAZZ EUROPE TOURS

JAZZ EUROPE                                                                                                      JAZZ EUROPE COMBOS         

MONTREUX JAZZ, Switzerland        [   ]                                                          MONTREUX  & NORTH SEA                              [   ]         

JAZZASCONA, Switzerland               [   ]                                                          NORTH SEA & MONTREUX                               [   ]

NORTH SEA JAZZ, Holland               [   ]                                                          NORTH SEA, PARIS & JUAN                             [   ]

JAZZ A JUAN, French Riviera          [   ]                                                          MONTREUX & JUAN                                          [   ]

LONDON JAZZ, England                    [   ]                                                          JAZZ EUROPE GRAND TOUR                            [   ]

]                                                                                                                              MY CUSTOM ITINERARY                                   [   ]

                                                                 

Mr. Mrs. Ms. Dr.__________________________________________________________________      ____//____//____

                                                Last Name                            First Name                            Middle                                   Date of Birth (TSA)           

                Your name, date of birth and gender Exactly as it appears on your passport                  [  ] male  [  ] female

 

Address: ____________________________             City__________________                State___               ZIP_____________

 Tour document delivery address-Signature required for delivery

 

Business/Day Tel______________________  Home Tel ____________________________ EMAIL____________________

 

………………………Traveling Companion………………………

 

Mr. Mrs. Ms. Dr.___________________________________________________________________    ____//____//____

                                Last Name                            First Name                            Middle                                    Date of Birth (TSA)

                               Your name, date of birth and gender Exactly as it appears on your passport                    [  ] male  [  ] female

 

Address: ____________________________             City__________________                State___               ZIP______________

 

Business/Day Tel ______________________  Home Tel _____________________________ EMAIL___________________

 

[   ]  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:______________________________________________________ Dates from: __/__/11  to __/__/11

 

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

 Montreux Stravinski [   ]  3 Nights $749,  [   ] 6 Nights: $1499         North Sea All-In Pass 3 nights: $399

 

TOUR PRICE ___________ X  Number of Persons ___ =  TOTAL ____________

A deposit of  $600 (Economy-Superior1st Class hotels)/$1200 (Deluxe) 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:__________________    Email: _______________________

  

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 on our website: www.ciaotravel.com . CST 2010054-40            CT/TRF 0516