Email Trip Registration Form

TRIP REGISTRATION FORM

TRIP DATE*

DESTINATION*

HOW MANY TRAVELING IN YOUR PARTY*

Please do not list any passengers signing up separately

TRAVELING WITH*

Myself OnlySpouseFriendFriend (signing up separately)

PASSENGER NAMES*

List yourself and all passenger name(s) that your registering. PLEASE DO NOT list any one who is registering separately.

HOME PHONE*

MOBILE PHONE*

ADDRESS*

CITY, STATE, ZIP CODE*

EMAIL ADDRESS*

PREFERRED PICK UP LOCATION*

Lanoka Harbor, WalmartToms River, NJT bus park n rideBrick, TargetMonmouth Service Plaza (NB only trips)Cheesequake Service Plaza (NB only trips)

PREFERRED BUS SEATING ** NOT GUARANTEED ***

Front Area Rows 1-7Middle Area Rows 8-12Rear Area Rows 13-16

List friends that registered separately to be seated with you

HOTEL ACCOMMODATIONS ( Multi-Day tours only )

1 Room2 Rooms

ROOM ACCOMMODATIONS ( Multi-Day tours only )

1 King2 Queens / 2 Doubles

PAYMENT OPTIONS*

Mailing Check / Deposit OnlyMailing Check / Full PaymentCharge Card

PAYMENT BY CHECK

PAYMENT BY CHARGE CARD

VisaMastercardDiscover

Card Number

Expiration Date

3 digit code

Located on back of card

Charge Cards Only

DEPOSIT ONLY - Final payment will be billed to you.DEPOSIT / FINAL PAYMENT - Final payment billed to same card.FULL PAYMENT - Payment in full at time of booking.

I am allowing Garys Fun On Wheels Tours to charge my credit card for trip including a 3% convenience fee.(Excluding Cruises)

RESPONSIBILITY STATEMENT - Garys Fun on wheels tours,Lanoka Harbor,NJ, is not liable or responsible for the faults of vendors or persons providing services to carry out tour services, not responsible for parking issues,personal items, itinerary changes including cruises, hotel substitutions for the comfort & safety of the passengers. event or attractions as necessary, for any reason such as terrorism, weather, traffic, acts of god, strikes, nature or issues beyond the control of fun on wheels tours. I acknowledge that Fun on wheels tours and their directors, officers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Fun on wheels tours.*

I agree with the terms and conditions

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Thank you for your reservation You will be receiving your confirmation email shortly Thank you for traveling with Garys Fun On Wheels Tours,LLC Mail Check Payment To Garys Fun On Wheels Tours P.O Box 211 Lanoka Harbor, NJ. 08734

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