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Registration Form
Thank you for trusting Jennifer Hutchings from Magical Trips TPI with your booking! Please NOTE this form does NOT confirm your travel, we will take this information and send you a separate confirmation once booked.
Travel Advisor's Name
*
Travel Advisor's Email Address
*
Kindly ensure that the names you are providing for yourself are the legal names as per your passports. Please note that misspelled or incorrect names could cause denial of boarding!
Title
*
Mr
Mrs
Ms
Mstr
Miss
Mx
First name
*
Last Name
*
Middle Name or Initial (if/as shown on passport)
Date of Birth (DD/MMM/YYYY)
*
Issuing country of Passport
Passport Number
Passport Expiry Date (DD/MMM/YYYY)
How many Passengers for this registration form?
*
Just me
2
3
4
5
6+
Passenger 2
Title
Mr
Mrs
Ms
Mstr
Miss
Mx
Passenger 2: First name
Middle Name or Initial (if/as shown on passport)
Passenger 2: Last Name
Date of Birth (DD/MMM/YYYY)
Issuing country of Passport
Passport Number
Passport Expiry Date (DD/MMM/YYYY)
Passenger 3 (if applicable)
Title
Mr
Mrs
Ms
Mstr
Miss
Mx
Passenger 3: First name
Middle Name or Initial (if/as shown on passport)
Passenger 3: Last Name
Date of Birth (DD/MMM/YYYY)
Issuing country of Passport
Passport Number
Passport Expiry Date (DD/MMM/YYYY)
Passenger 4 (if applicable)
Title
Mr
Mrs
Ms
Mstr
Miss
Mx
Passenger 4: First name
Middle Name or Initial (if/as shown on passport)
Passenger 4: Last Name
Date of Birth (DD/MMM/YYYY)
Issuing country of Passport
Passport Number
Passport Expiry Date (DD/MMM/YYYY)
Passenger 5 (if applicable)
Title
Mr
Mrs
Ms
Mstr
Miss
Mx
Passenger 5: First name
Middle Name or Initial (if/as shown on passport)
Passenger 5: Last Name
Date of Birth (DD/MMM/YYYY)
Issuing country of Passport
Passport Number
Passport Expiry Date (DD/MMM/YYYY)
Should you have more than 5 passengers travelling, please submit details in the additional information text box below
Billing Address
Your Email Address
*
Please confirm email address
*
Email address is required in order to receive a copy of the terms and conditions
Phone Type
Home
Mobile
Phone Number
Street Address
Address Line 2
City
State/Province
Zip/Postal Code
Please submit your credit card info below
Credit Card Type
*
Not Adding a Card
Visa
Mastercard
American Express
Name on Card
Amount to be charged
Credit Card Number
Expiration Date (mm/yy)
Please contact your Advisor directly if you are needing to communication your Credit Card's CVV/CVC code.
Emergency Contact Info (Optional)
Would you like to add an Emergency Contact?
*
No
Yes, 1 Emergency Contact
Yes, 2 Emergency Contacts
Emergency Contact #1 Name
Emergency Contact #1 Phone
Emergency Contact #1 Email
Emergency Contact #2 Name
Emergency Contact #2 Phone
Emergency Contact #2 Email
Your booking is non refundable and no changes are permitted unless otherwise stated
We strongly recommend the purchase of Travel Insurance. Would you like a quote on Travel Insurance?
*
We've already discussed, please ADD ON the insurance quoted to me
Send me a quote for the Cancel For Any Reason (CFAR) coverage
Send me a quote for the All-Inclusive Package (Most inclusive: Includes Trip Cancellation, Interruption, and Medical, as well as Baggage loss or delay, travel accident, etc.)
Send me a quote for Non Medical Package (Includes Cancellation & Interruption, but NO Medical coverage)
I'm not sure could you call me to discuss further?
I am DECLINING all travel insurance and will not hold the Travel Agent responsible for any potential losses that may occur
Any Additional Comments/Requests