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Cunard 4th of July Aboard Queen Mary 2 in 2009

This is a BOOKING FORM . Do not use this form to submit inquires.

Please fill out this form completely as possible . If you do not wish to provide your credit card information you will be contacted by the travel agent for your credit card information.

Deposits will be charged immediately once Cunard opens the sailing for booking and you will see a charge directly from the cruise line on your credit card statement.

YOUR TRAVEL AGENT IS:

Nina Van Harn

Ambiance Travel
http://ambiancetc.com/

Phone number: 1-616-405-6950
Fax number: 1 (866)762-2709
E-mail: Nina@ambiancetc.com

Form is for ONE CABIN. If you need more than one cabin please submit a form for each cabin you need to book.

Name:*

E-mail:*

Phone:*

Street Address*

City/Town*

State (For USA residents)

Zip or Postal Code

If you live outside of the USA please provide your address in full, including country here

Please note that MOST categories only hold 4 passengers maximum - including children. If you have more than four passengers please consider booking two or more cabins as necessary.

Cabin Type*

Bed Configuration*

Special requests

Roll Away Bed Bed Extender Handicap Room Adjoining Rooms Other

Place any special requests for specific cabin location (such as an aft cabin or a specific cabin number) or special cabin needs such a handicap or adjoining rooms here

Early usually is around 6 pm and late dining is usually around 8:30 pm.

My first dining choice time is:*

Early Late Either Single Seating (Category AA, Princess Grill and Queen\'s Grill Only)

If you have any special diet needs such as vegetarian, Kosher or similar request please enter it here

Passenger 1

Full Legal Name As Shown On Your Passport*

Passenger 1 Date of Birth*

Month Day Year

Please confirm you are at least 21 years old*

Yes No

Passsenger is*

Male Female

If you have a World Club Number Please Enter It Here

Do You Need Air?*

Yes No

If yes please enter your desired city or airport

Would you like insurance?*

Yes No

Your Country of Citizenship*

Do you have a passport from your Country of Citizenship that will be valid through the end of 2009?*

Yes No

If yes, please provide the Country that issued your Passport

Passport Number

Passport Date of Issue

Passport Date of Expiration

Passenger 2

Full Legal Name As Shown On Your Passport

Passenger 2 Date of Birth

Month Day Year

Passenger is

Male Female

If Passenger 2 has a World Club Number please enter it here

Does Passenger 2 require air?

Yes No

If yes please enter the desired city or airport

Would Passenger 2 like insurance?

Yes No

Passenger 2 Country of Citizenship

If yes, please provide the Country that issued the Passport

Does Passenger 2 have a passport from their Country of Citizenship that will be valid through the end of 2009?

Yes No

Passport Number

Passport Date of Issue

Passport Date of Expiration

Passenger 3

Passenger 3 Full Legal Name As Shown On Passport

Passenger 3 Date of Birth

Month Day Year

Passenger is

Male Female

If Passenger 3 has a World Club Number please enter it here

Does Passenger 3 require air?

Yes No

If yes please enter the desired city or airport

Would Passenger 3 like Insurance?

Yes No

Passenger 3 Country of Citizenship

Does Passenger 3 have a passport from their Country of Citizenship that will be valid through the end of 2009?

Yes No

If Yes please provide the Country that Issued the Passport

Passport Number

Passport Date of Issue

Passport Date of Expiration

Passenger 4

Passenger 4 Full Legal Name as shown on Passport

Passenger 4 Date of Birth

Month Day Year

Passenger 4 is

Male Female

If Passenger 4 has a World Club Number please enter it here

Does Passenger 4 Require Air

Yes No

If yes please enter the desired city or airport

Would Passenger 4 like Insurance

Yes No

Passenger 4 Country of Citizenship

Does Passenger 4 have a passport from their Country of Citizenship that will be valid through the end of 2009?

Yes No

If yes please provide the Country that issued the Passport

Passport Number

Passport Date of Issue

Passport Date of Expiration

Credit Card Type

VISA MasterCard American Express Discover

Credit Card Number

Credit Card Expiration Date

Three or Four digit security code

Name on the Credit Card

Are you the card holder?

Yes No

By checking this box, I authorize Ambiance Travel to charge my credit card

Yes, Charge My Card

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Cunard Line Cancellation and Refund Policy

The following policies shall apply to any and all Cunard cruisecancellations.We highly recommend Travel Insurance to protect yourselffrompenalties assessed for canceling due to medical reasons for yourself orfamilymembers.

Cancellation Charges for Sailings of 40 Days or Less
Days Prior to Departure	Cancellation Charge Per Guest
Up to 95 days prior to departure	$50 per person
94 days to 65 days prior to departure	25% of Total Fare + $50 per person
64 days to 35 days prior to departure	50% of Total Fare + $50 per person
34 days to 20 days prior to departure	75% of Total Fare + $50 per person
19 days to date of departure	100% of Total Fare
No Appearance	100% of Total Fare

Cancellation Charges for Sailings of 41 Days to 80 days
Days Prior to Departure	Cancellation Charge Per Guest
Up to 125 days prior to departure	$50 per person
124 days to 95 days prior to departure	10% of Total Fare + $50 per person
94 days to 65 days prior to departure	50% of Total Fare + $50 per person
64 days to 35 days prior to departure	75% of Total Fare + $50 per person
34 days to date of departure	100% of Total Fare
No Appearance	100% of Total Fare

Cancellation Charges for Sailings of 81 days or More
Days Prior to Departure	Cancellation Charge Per Guest
Up to 125 days prior to departure	$50 per person
124 days to 95 days prior to departure	25% of Total Fare + $50 per person
94 days to 65 days prior to departure	50% of Total Fare + $50 per person
64 days to date of departure	100% of Total Fare
No Appearance	100% of Total Fare

The above cancellation penalties apply to all travel includingcruise,airfare, land arrangements, including optional hotel/land extensions.Ifnon-cruise components only are cancelled, the guest will be responsiblefor anycancellation penalties imposed by the airlines, other transportationcarriers,tour and ground operators or hotel properties. Air cancellations aresubject to a $100 penalty per person if the air is cancelled aftertickets areissued. All requests for cancellations must be made IN WRITING. Yourtravel agent must telephone Cunard's Reservation Departmentto cancel your reservations.

Refunds

Before a determination regarding a refund can be made, all cruise and airdocuments must be returned to Cunard Line, Refund Department. Partial useof cruise, airfare, hotel and land extension does not qualify guest for arefund. All refund requests pertaining to cruise, land and air are subjectto final review by Cunard.

Instructions

Cruise Freek Forums - Booking Form

Select Your Cabin

Dining

Passenger Information

Credit Card Information

Cunard Line Cancellation and Refund Policy

Refunds