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1.800.725.4260

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TOUR REGISTRATION FORM

Please read the Terms & Conditions of Registration before completing this form.

Fields marked with * must be completed

or the form will not send.

Tour of interest

First Name

Last Name

Preferred name (for tour material)

How did you find out about us?

Phone

Cell Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Citizenship

Date of Birth (year/month/day)

Emergency contact

Relationship to you

Emergency contact phone

Are you registering as a single or for two? *

Single

Double

Do you require an ADA room? *

Yes

Number of beds required *

One

Two

Do you prefer a bathtub or shower? *

Bathtub

Step-in shower

How would you rate your mobility? *

Excellent

Fair

I use a cane / walker / wheelchair

Please list any food allergies or dislikes

2nd traveler's first name

2nd traveler's last name

2nd traveler's email

2nd traveler's phone

2nd traveler's cell phone

2nd traveler's Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Date of Birth (year/month/day)

Citizenship

2nd traveler emergency contact

Relationship to 2nd traveller

Emergency contact phone

How would you (2nd traveler) rate your mobility?

Excellent

Fair

I use a cane / walker / wheelchair

Please list any food allergies or dislikes for 2nd traveller

Do you require an insurance brochure? *

Yes

Do you require Aria Tours baggage tags? (answer yes if you have not travelled with us before or if you have but you require more tags)

Yes

NOTES

I acknowledge that I have been advised to purchase travel insurance and I decline.

I agree to the terms & conditions of registration *

Contact

Aria Tours
P.O. Box 159
Almonte, ON
Canada K0A 1A0

Email: info@ariatours.com

1.800.725.4260

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