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Independence Day Celebration Cruise Share Request

Please put me on the roommate share list for PIED PIPER's Independence Day Celebration Cruise. Fields marked with* are Required.

Email Address*

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Confirm Address*
First Name*
Last Name*
Gender * Male Female
Address*
Address 2
City*
State/Province* Choose 'N/A' for non-US/Canadian addresses
Zip/Postal Code*
Country*
Home Phone #*
Cell Phone #
Work Phone #
Can we leave a message?YesNo
Please tell us how you heard of us:*
(Which magazine/publication?, Which webpage?, From a friend/previous passenger? etc.
Do you currently have a favorite travel agent? (PIED PIPER pays commissions to certified travel agents for its gay group cruises!) No Yes
Travel Agent Name:
Travel Agent Email:
Travel Agent Tel:
Travel Agent Fax:
Travel Agent Address:
Which categories would you like to be listed for?
IF - Standard inside, forward $1,662
iE - Standard inside, forward or aft $1,709
IC - Standard inside - Higher deck forward or aft $1,757
IB - Standard inside - Lower deck midship $1,989
IA - Standard inside - Higher deck midship $2,099
HB - Atrium View inside - Lower deck midship $2,149
EF - Oceanview - Lower deck Forward or aft $2,184
DF - Balcony - Forward $2,459
DC - Balcony - Obstructed View, Higher Deck Forward or Aft $2,279
DB - Balcony - Obstructed View, Midships $2,279
BZ - Sheltered Balcony - Lower Deck Forward $2,619
BY - Sheltered Balcony - Lower Deck Aft $2,469
BV - Sheltered Balcony - Lower Deck Forward or Aft $2,564
BU - Sheltered Balcony - Lower Deck Midships $2,659
BF - Balcony - Forward $2,754
BC - Balcony - Higher Deck Forward or Aft $2,849
BB - Sheltered Balcony - Lower Deck Midship $3,249
A2 - Club Balcony - Higher Deck Forward $3,669
A1 - Club Balcony - Higher Deck Midships or Forward $3,829
P2 - Junior Suite $5,219
P1 - Junior Suite $5,034
Q7 - Suite $6,269
Q6 - Suite $6,269
Q5 - Suite $5,984
Q4 - Penthouse Suites $9,419
Q3 - Royal Suites $10,259
Q2 - Duplex Apartment $18,869
Q1 - Grand Duplex Apartment $25,169
KC - Outside single cabin $4,038
KB - Outside single cabin $4,145
Would you like a smoker or non-smoker as a roommate?
Non-smoker Smoker
 
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Thank you for your interest in our cruises! We will call you as soon as we find a roommate for you to make sure you're still interested. Hope to see you onboard!
PLEASE NOTE THAT ALL PAYMENTS MADE FOR SHARE RESERVATIONS ARE NON-REFUNDABLE UNLESS A SHARE REPLACEMENT CAN BE FOUND