Capricorn Beach Bash

Step 1: Guest Information

Where did you first hear about us?

Total Number of Guests:

Guests 1 Information - If we are making an air reservation, Guest name MUST match passport exactly in order to board airplane.

Guest Title :

First Name *:

Middle Name :

Last Name *:

Suffix :

Preferred First Name :

Guest DOB*:

Please provide a valid date in the "MM/DD/YYYY" format

Gender * :

Passport Issuing Country :

Passport Exp :

Please provide a valid date in the "MM/DD/YYYY" format

Frequent Flyer Number

Step 2: Contact Information Click here to give us more info...

Your Country :

Street Address *:

City *:

State/Province :

Zip/Postal Code :

Whose address is this? :

Email Address * :

Email Address 2 :

Phone Number *:

Step 3: Trip Information Click here to give us more info...

Departure Date *:

Please provide a valid date in the "MM/DD/YYYY" format

Return Date *:

Please provide a valid date in the "MM/DD/YYYY" format

Trip Name

Room/Cabin Type * :

Transportation Type * :

Bedding Type :

Need ADA accomodations?

Departure Airport :

Trip Type

Do you need airfare?

Yes No Flights Already Purchased

Active Military/Veteran :

Yes No

Travel Protection * :

Yes No

We cannot add Cancel For Any Reason travel protection after deposit, however, we can add other traditional protection at a later date. By purchasing travel protection, I understand that the cost of the policy itself is non-refundable at all times - no exceptions. By checking no, you agree with this statement: I understand that without insurance, all payments are NON-REFUNDABLE AND NON-TRANSFERABLE. We HIGHLY recommend the purchase of travel insurance.

Step 4: Payment Information (optional) Click here to give us more info...

Payment Type :

Amount Authorized - Please verify required amount in Instructions:

Submit an additional payment type: Yes No

CVC Code

Step 5: Additional Information Click here to give us more info...

Special Requests :

Future Destinations Interests?

Other Questions/Comments :

Is there anyone to thank for your referral?

* IMPORTANT Please DOUBLECHECK names are entered AS ON PASSPORTS or as WILL BE on passports. Additional fees may apply if a reservation has to be changed due to incorrect information. Group Escapes 4 Less, Inc. d/b/a Your Group Escapes is not liable if the information is not entered correctly! By submitting, you certify that you are the cardholder and are authorizing the travel agency or its chosen Tour Operator/Supplier/Cruise Line to charge the listed amount to the credit card. You certify that you have verified that all information contained in the confirmation you received is accurate. You also certify you have read the Terms & Conditions and the appropriate Travel Protection Plan details. Cancellation penalties may apply. Insurance is not refundable. This charge will be manually applied by the agency to your reservation. If there are any issues, an agent will get back to you. Please note that you may not see a charge from the travel agency on your credit card statement; the charge may come from our supplier and/or the airline directly. Payment may take 3-5 business days to fully process and be reflected on your statement. I authorize the travel agency to use the above information to charge my credit card the stated amount. Completion of this form and the initialing of this box signifies acceptance in lieu of my signature. By checking the box below and adding your signature, you indicate that the above amount is correct, you authorize the travel agency to charge your credit card for the specified amount, and you agree to the terms and conditions.

I Agree *

Capricorn Beach Bash - Jamaica