Tour Reservation Form

TOUR RESERVATION FORM

INSTRUCTIONS: Please carefully read the Terms and Conditions accompanying this page. Complete all sections, sign and date form below and return immediately via fax or mail. This form is required no later than final payment date. Tour documents cannot be issued and passengers will not be permitted to participate on a Palace Travel program, if this completed Reservation Form is not received in our offices prior to departure. Cancellation penalties will still apply. Please PRINT in black ink. Please make additional copies as needed.

TOUR NAME: ______________________________

TOUR DATES:_______________

ROOM TYPE REQUESTED (Please check box): ( ) Double ( ) Twin ( ) Single

Please note: Double room implies room with 2 guests sharing a double, queen or king bed, as available at time of check in. We cannot guarantee any specific bed type in advance. Twin room implies room with 2 twin beds. Single supplement applies when Single room is requested. Singles requesting a share in twin room will be charged a single supplement if a share is not located.

Please reserve _____ place(s) on the __________________________ (Name of Tour )

( ) I would like single hotel accommodations for the additional cost quoted.

( ) I plan to share hotel accommodations with: ______________________________

( ) I am willing to share with another participant

( ) Non-smoker (Shares will not be guaranteed) ( ) Smoker

Enclosed is my check of $ __________ ($500 per person) for __________ persons.

Please make check payable to: PALACE TRAVEL, INC. and return this completed form to 5301 Chestnut Street, Philadelphia, PA 19139.

Please charge my deposit of $ ________ to ( ) AMEX ( ) Visa ( ) Master Card

Credit Card Number: _____________________________________________________________
(Attach copy of front and back of credit card)

PASSENGER

(1) NAME: (AS IT APPEARS IN PASSPORT) ______________________________________________

SEX: ( ) MALE ( ) FEMALE

DATE OF BIRTH: _________

NATIONALITY: __________

SMOKER: ( ) YES ( ) NO

PASSPORT NO.: ________________

ISSUE DATE:_________ EXP. DATE: _______

DIET/MEDICAL RESTRICTIONS: ____________________________________

STREET ADDRESS: ________________________________________________

CITY, STATE, ZIP: _________________________________________________

TELEPHONE (WORK):_____________________

(HOME): _____________________ (CELL): ____________________

E-MAIL: __________________________________

PASSENGER (2)

NAME: (AS IT APPEARS IN PASSPORT) ______________________________________________

SEX: ( ) MALE ( ) FEMALE

DATE OF BIRTH: __________

NATIONALITY: _________

SMOKER: ( ) YES ( ) NO

PASSPORT NO.: ______________

ISSUE DATE: ________ EXP. DATE: __________

DIET/MEDICAL RESTRICTIONS: ___________________________________

STREET ADDRESS: _______________________________________________

CITY, STATE, ZIP: _______________________________________________

TELEPHONE (WORK): __________________

(HOME): ________________________ (CELL): ___________________

E-MAIL ADDRESS:___________________________

IN CASE OF EMERGENCY, PLEASE CONTACT:_____________________________

RELATIONSHIP: ________________

TELEPHONE (DAY): _________________ (EVEN): ________________

FINAL PAYMENT DUE 60 DAYS BEFORE DEPARTURE

Signatures required of above passengers. I agree to abide by the PALACE TRAVEL’s Terms and Conditions accompanying this form, and will be bound by these Terms and Conditions. If passenger is under the age of 18, parental signature is required.

PASSENGER (1)

SIGNATURE: __________________________ DATE: _______________

PASSENGER (2)

SIGNATURE: __________________________ DATE: _______________

AGREEMENT TO TERMS AND CONDITIONS

The advance payment OR any other partial payment for a reservation constitutes consent to all provisions of the Terms and Conditions listed at http://www.palacetravel.com/content/terms.

PASSENGER (1)

I have read, understand, and consent to the Terms and Conditions listed at PalaceTravel.com.

PRINT NAME _______________________________________ BOOKING # ________

SIGNATURE __________________________________________ DATE ____________

PASSENGER (2)

I have read, understand, and consent to the Terms and Conditions listed at PalaceTravel.com.

PRINT NAME _______________________________________ BOOKING # ________

SIGNATURE __________________________________________ DATE ____________

A reservation form must be fully completed, signed and received by Palace Travel no later than final payment date. Correct passport names must be provided at time of reservation and on the reservation form. Palace Travel will not be responsible for any consequences due to errors as a result of misspelled names on these lists. Name changes are not permitted and the booking will be subject to availability and new fares. Any action or inaction taken by an airline is entirely beyond the control of Palace Travel. Name changes on air Reservations result in automatic cancellation of the existing air reservation by the airline.

Re-issuing of tickets will be subject to individual airline Terms & Conditions and penalties will apply without exception. The final documents will not be issued if the reservation forms are not received by Palace Travel. A signed reservation form is an acceptance of the tour program, rate confirmed, and constitutes acceptance of the tour program, as well as the Terms & Conditions by the traveler.

Please print the reservation form and send it to us via fax or postal mail:

Fax:

(215)471-8898

Mail:

Palace Travel
5301 Chestnut Street
Philadelphia, PA 19139

Need help or have questions? Call us:

1-800-683-7131 or 1-215-471-8555