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Booking Form

*Required Information

1.) BOOKING PROCESS & AGREEMENT - EUREKA TRAVEL:

  1. To book your trip with Eureka Travel you may fill out our secure online form or print it out and fax it to 818-841-8624.
  2. Accepted forms of payments are credit card (Visa, MasterCard, Discover, & American Express) are accepted or a check payable to Eureka Travel. Reservations are subject to check clearance. A $25 fee will apply for returned/cancelled checks.
  3. For land services deposit of 25% is due upon confirmation. Balance is due 60 days prior to travel. If confirmation is made less than 60 days prior to travel, full payment is required. The deposit of 25 % does not guarantee the prices unless the entire trip is paid in full.
  4. For flights a full payment is required and it is separate from the 25% deposit as stated above in item C.
  5. For more information please refer to our terms and conditions.
  6. Your check must be received within 5 business days from the time you submit the booking form to start the process of your reservation. The confirmation of the reservation is subject to check clearance.
  7. After we receive your deposit we will start the process of reservations and reply via e-mail within three business days.
  8. Within 10 business days of receiving full payment for your trip, we will send you your final confirmation via email & mail with additional details about the trip, vouchers, contact information etc.
  9. By submitting this form, you agree to the terms & conditions of EUREKA TRAVEL.

2.) TRIP NAME OR DESTINATION:

3.) DEPARTURE DATE:

*Month: Day: Year:

4.) *NUMBER OF TRAVELERS IN YOUR GROUP:

5.) ROOMING PREFERENCE:

*Rooms: *Adults: *Children under 12 years old:

6.) PRIMARY TRAVELER INFORMATION:

*First Name:
 *Last Name:
*Street Address:
 *City:
*State:
or Province:
*ZIP or Postal Code:
 *Country:
*Nationality
 Date of Birth (MM/DD/YYYY):
*Passport Number:
 Passport Expiration Date (MM/DD/YYYY):
*Email:
 *Phone:
Cell or Other Phone Contact:
 *Emergency Contact/Phone & Name:

7.) ADDITIONAL TRAVELERS:

No Additional Travelers

Traveler 2  
*First Name:
 *Last Name:
*Passport Number:
 Passport Expiration Date (MM/DD/YYYY):
*Nationality
 Date of Birth (MM/DD/YYYY):
*Email:
  
Traveler 3  
*First Name:
 *Last Name:
*Passport Number:
 Passport Expiration Date (MM/DD/YYYY):
*Nationality
 Date of Birth (MM/DD/YYYY):
*Email:
  
Traveler 4  
*First Name:
 *Last Name:
*Passport Number:
 Passport Expiration Date (MM/DD/YYYY):
*Nationality
 Date of Birth (MM/DD/YYYY):
*Email:
  

8.) PAYMENT INFORMATION:

*Credit Card:
  
*Name on Card:
 *Card Number:
*Security Code:
*Expiration Date (MM/YY):

Billing Address of Credit Card Holder:

*Street:
*City:
*State:
or Province:
*ZIP or Postal Code:
*Country:

9.) AMOUNTS DUE:

A) Airfares:

International Flights Per Person U$D
Domestic Flights Per Person U$D
No Flights Needed
Total Per Person U$D
Total x Persons U$D

FULL PAYMENT IS REQUIRED FOR ALL FLIGHTS at the time of booking

B) Land Services:

Total price trip per person LAND PORTION: U$D
Total x persons LAND PORTION: U$D
25 % deposit (land portion) per person: U$D
Today’s Date (MM/DD/YYYY):
75% Remaining balance (land portion) will be charged automatically 60 days prior starting the trip
per person: U$D
Final Payment Due Date (MM/DD/YYYY):
Notes:
25% of LAND portion deposit + FULL FLIGHT(s) PRICE is required per person to confirm your reservation.

The remaining balance of 75% (LAND portion) will be automatically charged 60 days prior to the departure if there are no cancellations or changes.

Full payment (100% land + flights) is required if your trip departs within 60 days of your booking.
Signature primary participant /credit cardholder:

10.) PRICES & CHANGES:

Please be advised that the price given to you at time of reservation is an estimate and only reflects the prices at the time of your reserving your travel arrangements with Eureka Travel. Prices changes may include but are not limited to airline fee and tax increases, currency fluctuations, supplier rates increases, all of which are beyond Eureka Travel's control and are subject to change without any notice. You can guarantee the price only by FULL PAYMENT at time of reservation. Passenger acknowledges that Eureka Travel is not responsible for any price increases and that the passenger will be responsible for paying the full amount. Eureka Travel will do its best to keep the passenger informed about any prices increases as Eureka Travel becomes aware of them.

11.) TRAVEL INSURANCE:

Yes, I have purchased Travel Insurance Plan.
I do not have travel insurance and I would like to receive a quote for it.
No, I do not wish to purchase insurance protection at this time. I acknowledge that I have been offered coverage and choose to decline.

12.) COMMENTS & QUESTIONS:

How did you learn about EUREKA TRAVEL?

Web Search
Facebook
Blog
Word of Mouth
Events

Other:

Any Additional Comments/Requests (diet/medical conditions, etc):

13.)  I AGREE TO EUREKA TRAVEL TERMS & CONDITIONS.



  


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Eureka Travel | CST# 2084597-40 | PO Box 7384, Burbank, CA 91510-7384 | USA Phone: (+1) 818-841-8624 | info@eurekatravel.net

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