FIESTA TRAVEL DESIGNS
Basic Registration Form - Good for Any Cruise We Offer
Note: Printable registration forms are available on information pages
for 'group' cruises offered by this agency.
*Required field
Your name
as written on
drivers license,
passport, or I.D.:
*
Full Address,
Include City,
State and Zip:
*
*
 Home Phone:
Cell Phone:
*
Date of Birth:
Your email
address:
*
Which cruise are
you registering for?
(include dates)
*
How did you find out
about this cruise?
Type of Cabin
Requested:
(Inside, Oceanview,
Balcony, or Suite)
*
*
Cost of Cruise:
Your cabinmate:
(if known at this time)
Include Date of Birth
PAYMENT INFORMATION: Initial deposit may be made
by credit card, debit card, check, or money order.
If sending check or money order, indicate amount in
large block of space at bottom (see #1 below).
Type of Credit Card:
(VISA, Master Card,
American Express,
Discover)
Credit Card Number:
Expiration Date:
Name on Card:
    Amount to be charged:
         Indicate $ amount
  
   Credit/Debit cards may
              be used for:
     (1)  Initial payment  
     (2)  Initial payment   
        plus future payments
     (3) Only future payments

Check or money order may  
      be mailed for any or all
                payments
PLEASE PROVIDE THIS INFO IN SPACE BELOW:

1) If mailing check or money order for deposit ( instead of using
credit card or debit card),  indicate amount of check/m.o.

2) For those registering for the "Elvis Entertainers Network"
Cruise, please tell us WHICH ELVIS TRIBUTE ARTIST
should receive credit for your participation in this cruise.

3) Do you have any special medical needs?

4) Do you prefer early dining (6pm), late dining (8:15pm),
or the new "Anytime Dining" (5:45 - 9:30 p.m.)

5) Do you want Travel Insurance?

6) Do you want to Pre-Pay  your Gratuities?

7) Give emergency contact Information for you
and your cabinmate:
(Name & Phone Number of contact person)

Note: This online form must be filled in for each person traveling,
unless cabinmate info is included in section below.
(Name, Date of Birth, Address, Phone#, & Payment Info)
To complete the registration process, if you did NOT give credit card/debit card
information, mail check or money order for initial deposit to:
Fiesta Travel Designs, 511 Stubbs Avenue, Monroe, LA 71201
Send note indicating for which cruise you are registering.
You will only be registered when initial payment is received in our office.
For FUTURE payments, you may provide Credit Card Information above.
For information, email us at: dianegaines@hotmail.com