FIESTA TRAVEL DESIGNS
Basic Registration Form - Good for Any Cruise We Offer
(Please allow 7 days to receive response from your email)
*Required field
Your name:
*
Full Address,
City, State, 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
Type of Credit Card:
(VISA, Master Card,
American Express,
Discover)
Credit Card Number:
Expiration Date:
Name on Card:
Amount to be
charged:
Or, are you mailing
a check?
YES or NO
If so, for what amount?
PLEASE PROVIDE THIS INFO IN SPACE BELOW:

1) 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.

2) Do you have any special medical needs?

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

4) Are you interested in obtaining Travel Insurance?

5) What about Pre-Paid Gratuities?

6) Emergency Contact Information for you and your cabinmate:
(Name & Phone Number of contact person)

Note: This 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, mail check or money order to:
Fiesta Travel Designs, 511 Stubbs Avenue, Monroe, LA 71201
Or, provide Credit Card Information above.
Indicate amount of check or amount to be charged to credit card.
For information, email us at: fiestatraveldesigns@hotmail.com