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TRIP DATE

DESTINATION

HOW MANY TRAVELING (Include Yourself)*

TRAVELING WITH (Staying In Your Room)*

PASSENGER NAMES (Include Yourself)

PHONE (Please Check One)*

CONTACT NUMBER*

ADDRESS*

CITY, STATE, ZIP CODE*

EMAIL ADDRESS*

PREFERRED PICK UP LOCATION*

PREFERRED BUS SEATING ** NOT GUARANTEED ***

List friends that registered separately to be seated with you

SPECIAL OCCASION (While Traveling With Us)

DATE OF SPECIAL OCCASION

HOTEL ACCOMMODATIONS *

ROOM ACCOMMODATIONS *

PAYMENT OPTIONS*

PAYMENT BY CHECK ($100.00 DEPOSIT PER PERSON)

PAYMENT BY CHARGE CARD

Card Number

Expiration Date

3 digit code

Billing Zip Code

Charge Cards Only

I am allowing Garys Fun On Wheels Tours LLC, to charge my credit card for trip including a 3% convenience fee.(Excluding Cruises)

RESPONSIBILITY STATEMENT - Garys Fun on wheels tours,Lanoka Harbor,NJ, is not liable or responsible for the faults of vendors or persons providing services to carry out tour services, not responsible for parking issues,personal items, itinerary changes including cruises, hotel substitutions for the comfort & safety of the passengers. event or attractions as necessary, for any reason such as terrorism, weather, traffic, acts of god, strikes, nature or issues beyond the control of fun on wheels tours. I acknowledge that Fun on wheels tours and their directors, officers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Fun on wheels tours.*

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