Iceland and Northern Lights Registration

Personal Information and Travel Preferences

Name *

Date of Birth *

Gender *

Country of Citizenship *

Mailing Address *

City *

State *

Zip *

Email *

Cell Phone

Home Phone

Share Room With

Bedding Choice

One Bed

Two Beds

IF SECOND TRAVELER SHARING ROOM HAS THE SAME ADDRESS AND METHOD OF PAYMENT, PLEASE COMPLETE BELOW. IF NOT, PLEASE COMPLETE SEPARATE REGISTRATION FORM FOR SECOND PERSON.

Name (As It Appears On Passport)

Date of Birth

Gender

Country of Citizenship

Cell Phone

Emergency Contact Name and Phone For Both Guests *

Dietary Restrictions (Specify For Which Guest)

Valid Passport (with at least 6 months validity from your return travel date) is required. Please attach a copy of your passport photo information page to this registration form.

Passport Photo Information Page

Maximum file size: 26.21MB

Payment and Credit Card Authorization

Payment *

Check

Credit Card

Check Info

I am enclosing Check #

in the amount of $

for

traveler(s).

(Minimum deposit $200 per person)

Credit Info

Charge my credit card for the deposit amount of $

for

traveler(s).

(Minimum deposit $200 per person)

Travel Insurance

I would like to purchase Travel Insurance Policy

Air Quote

I would like an air quote.

I will pay by

Credit Card

Check

Check Number

If Paying by credit card, please complete below

Credit Card Type

American Express

Discover

Mastercard

Visa

Credit Card Number

Expiration

CVC

Name of Cardholder

Billing Address and phone if different than registration

Would you like to use this card for all future payments?

Yes

I agree to pay according to the card issuer agreement. I understand and accept the Tour Plan International and Europe Express cancellation policy, passport requirements, terms and conditions. I authorize the use of my credit card as a guarantee for cancellation

Signature

Clear

Marketing Permission

I agree to the following marketing permissions:

Email Communications:

Yes

Inclusion in group directories:

Yes

Use of likeness in photographic marketing materials:

Yes

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