PASSENGER INFORMATION |
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FIRST PASSENGER INFORMATION |
E-mail * |
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Have you registered on PiedPiperTravel.com before? If so, you can log in and we'll fill out your name/address information > Log in |
First Name * |
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Middle Name |
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Last Name * |
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Gender * |
Male Female |
Reservation number for existing reservations |
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Address * |
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Address 2 |
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City * |
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State/Province * |
Choose 'N/A' for non-US/Canadian passengers |
Postal / ZIP Code * |
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Country * |
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World Club Number |
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Home Phone * |
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Cell Phone |
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Work Phone |
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Date of Birth * |
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I want my travel agent to handle this booking. (PIED PIPER pays commissions to certified travel agents for its gay group cruises!) No Yes |
Travel Agent Name |
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Travel Agent Email |
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Travel Agent Tel |
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Travel Agent Fax |
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Travel Agent Address |
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SECOND PASSENGER INFORMATION (Leave blank if traveling alone, you may indicate below if you would like to arrange a share.) |
E-mail * |
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First Name * |
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Middle Name |
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Last Name * |
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Gender * |
Male Female |
Address* |
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Address 2 |
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City * |
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State/Province * |
Choose 'N/A' for non-US/Canadian passengers |
Postal / ZIP Code * |
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Country * |
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World Club Number |
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Home Phone * |
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Cell Phone |
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Work Phone |
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Date of Birth * |
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CRUISE INFORMATION |
I wish to sail on the |
Christmas and New Years Caribbean Cruise CUNARD LINES QUEEN MARY 2 - December 22, 2025January 3, 2026 |
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CABIN INFORMATION |
I would like a cabin in the Category & per-person price selected: * |
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If not available, my second choice Category & per person price is: |
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Arrange Share |
No Yes |
For shares, are you a Smoker? |
No Yes |
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DINING REQUEST |
Late seating is suggested so that you may dine with other group members. As most of the group will be dining in the late sitting, if you request early dining we will most likely not be able to put you at a group dining table. Also, our group cocktail parties and other events are timed to coincide with the late dining sitting.
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I would like to request* |
Early Dinner Sitting Late Dinner Sitting |
Table size* |
Small (2) Large (8-12) |
Please seat us with the following passengers: One name per line, please |
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Please tell us if we should know anything about you including dietary needs, etc. |
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TRAVEL INSURANCE * |
Yes, please contact me with information regarding travel insurance
No, I will not be requiring travel insurance.
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PAYMENT INFORMATION * |
I am paying by check
(If paying by check, we must receive your payment by mail within 5 business days of submitting your form. Please make all checks payable to PIED PIPER
TRAVEL.)
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My credit card will be billed 25.00% of the cruise fare per person immediately to secure my reservation. Final Payment Due as per Payment Schedule, below. (E-mail will be sent with confirmation.)
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Credit Card Number: * |
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Expiration Date: * |
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I am authorizing Pied Piper Travel, the cruise line and the cruise operator to automatically charge deposits, service fees, payments, insurance (if applicable), flight payments (if applicable) and cancellation fees to my credit card in accordance with the payment schedule and cancellation policy. |
Card Holder's Name: * |
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ADDITIONAL CREDIT CARD |
If an additional credit card is supplied then all charges will be split evenly, unless alternate payment
instructions are provided in the comments section of this form.
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Credit Card Number: * |
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Expiration Date: |
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I am authorizing Pied Piper Travel, the cruise line and the cruise operator to automatically charge deposits, service fees, payments, insurance (if applicable), flight payments (if applicable) and cancellation fees to my credit card in accordance with the payment schedule and cancellation policy. |
Card Holder's Name: |
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DEPOSITS, FINAL PAYMENT AND CANCELLATION SCHEDULE PER PERSON |
Deposit Due at time of booking (Cancellation Fee $75) / 25% Cancellation fee applies 120 days prior to sailing / Final Payment Due 120 days prior to sailing (Cancellation Fee 40%) / 50% Cancellation fee applies 60 days prior to sailing / 75% Cancellation fee applies 30 days prior to sailing / No Refunds 15 days prior to sailing. |
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OTHER INFORMATION AND CONDITIONS |
Liability and Responsibility - Please read the following carefully.
Making a reservation and acceptance of tickets and/or vouchers shall be
deemed to be an acceptance of these conditions. PIED PIPER TRAVEL, the
tour operator, acts solely as an agent for the passenger. PIED PIPER
TRAVEL and
CUNARD LINES does not accept responsibility in whole or part for any
delay, loss, accidents, personal injury, sickness, medical expenses, or
property damage occasioned by fault or negligence of any person,
employee or company entrusted with the performance of such service from
whatever cause. The tour operator and cruise line will not be
responsible for any expense or inconvenience caused by late arrivals
and departures of trains, ships, airplanes, buses, autos or any changes
of schedule beyond its control. The tour operator and cruise line will
not accept responsibility for the loss of, or damage to your luggage,
money, jewelry, valuables or any other belongings whatsoever and
howsoever caused.
The tour operator is responsible for
all services to be provided in respect to this tour. All tour services,
including but not limited to hotel accommodations, restaurants, guide
services, ground transportation, and cruise transportations, are
furnished by contractors that are independent from, and that do not act
for or on behalf of or as agents of or as joint ventures with the air
carrier, cruise line or tour operator.
The right is reserved by the tour
operator to make any changes that might become necessary with or
without notice. The tour operator reserves the right to accept or
decline any person as a member of the tour at any time and to cancel
the tour if minimum space requirements are not met. The passenger
agrees to the use of his/her likeness in photo or video, unless
specifically specified otherwise in writing.
The sole and exclusive
responsibility of the air carrier and cruise lines shall be in
accordance with and as limited by the contract of carriage set forth in
the passenger's ticket, baggage check and tariffs issued by the
carrier/cruise line. The cruise line ticket and contract will be
included in passenger documents. The passenger ticket, when used, shall
constitute a sole contract between the airlines/cruise lines and the
purchaser of these tickets and/or passenger. These carriers and other
carriers are not responsible for any act, omission or event during the
time the passengers are not on board their planes or conveyances.
Deposit/Cancellation Policy Per Person - Any changes in passenger name will be considered a
cancellation. All deposits, payments, and cancellation fees are per
person. The purchase of trip cancellation insurance to protect the
passenger is strongly recommended and can be arranged by your travel
agent.
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AIRLINE FLIGHT RESERVATIONS * |
Arrange my flights? * |
No, I will arrange my own flights. (If checked, ignore rest of Airline Flight section)
Yes please send me a quote for airfare: (Leave blank if not applicable)
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Class: |
Economy Class
Business Class
First Class
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Gateway City: |
Enter Departure Airport City or Code |
Departure Date: |
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Departure Time: |
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Return Date: |
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Return Time: |
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OTHER SERVICES AND RESERVATIONS |
Please tell us if you need hotel reservations, car rental, transfer, etc. |
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TERMS AND CONDITIONS |
I agree to the tour operator (Pied Piper Travel) Terms and Conditions * |
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ELECTRONIC SIGNATURE / AUTHORIZATION * |
I verify that I am at least 21 years of age. I have read the above terms and conditions and acknowledge I have been offered travel insurance. |
Passenger 1 * |
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Date * |
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Passenger 2 * |
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Date * |
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EXTRA INFORMATION |
Where did you hear about us? |
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Comments Box |
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NOTE: Your reservation isn't confirmed until we have provided you with a booking number by phone or e-mail.
Please print this completed form for your records before hitting the submit button.
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