Name (Required): *

First Middle Last

Please complete this EXACTLY as it appears on your passport (for international travel) or government ID (travel within the United States only). Penalties for mistakes here will be assessed by tour operators.

Date of Birth (Required): *

MM / DD / YYYY

Gender on Passport or Travel ID (Required): *

Female

Male

Undisclosed

Please select the gender listed on your travel document. Some airlines are allowing an undisclosed gender.

Current Address (Required): *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone (Required): *

### - ### - ####

Email (Required): *

COVID-19 Vaccination Status: *

Fully Vaccinated

Not Yet Fully Vaccinated but Plan to Be

Not Yet Fully Vaccinated but Open to Vaccination for Travel

Not Yet Fully Vaccinated and Do Not Plan To Be

Child who is not eligible for vaccination at this time

"Fully vaccinated" is defined by the CDC as follows: "In general, people are considered fully vaccinated: 2 weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or. 2 weeks after a single-dose vaccine, such as Johnson & Johnson's Janssen vaccine."

This question is required as some destinations, resort brands, etc. are requiring vaccinations for travelers. Others may have different testing requirements for vaccinated and non-vaccinated travelers and your agent needs this information to best advise you.

Passport Information:

A valid passport book is mandatory for all international trips. Passport cards will not be accepted when traveling internationally via air. Travel with your passport is strongly advised for cruises.

Please indicate the following (Required) *

I have a passport book that will be valid for my trip dates or as required by the destination(s) I am visiting

My current passport book has expired but I will renew my passport in time for my departure date

I am in the process of applying for or plan to apply for a passport book. I understand that if I am denied a passport or the name I provide is different than that on my passport, I will be responsible for any associated fees

I am traveling within the U.S.

I am (Required): *

a U.S. Citizen

a U.S. Permanent Resident (Green Card Holder) or other Resident Alien holding a passport from another country

Other

Certain international itineraries may require visas for U.S. and non-U.S. citizens. Agent will provide resources for visa applications.

You may need to renew your passport prior to travel, depending on your destination. Individual country requirements can be viewed on the U.S. State Department's Website:

https://travel.state.gov/content/visas/en/general/americans-traveling-abroad.html

Destination Luxe Travel is not responsible for passport or visa requirements for individual travelers. Please contact your agent if you have questions or concerns.

Passport Number (OPTIONAL)

Issue Date (OPTIONAL)

MM / DD / YYYY

Expiration Date (OPTIONAL)

MM / DD / YYYY

You may need to renew your passport prior to travel, depending on your destination. Individual country requirements can be viewed on the U.S. State Department's Website:

https://travel.state.gov/content/visas/en/general/americans-traveling-abroad.html

Destination Luxe Travel is not responsible for passport or visa requirements for individual travelers. Please contact your agent if you have questions or concerns.

Issuing Country (OPTIONAL)

TSA Pre-Check or Global Entry Program #(OPTIONAL)

If you are a member of the TSA PreCheck or Global Entry programs, please enter your # here. Note TSA PreCheck is not guaranteed for every flight based on the airports and airlines participating and is only for domestic flights.

Redress Number (OPTIONAL)

If you have a redress number, please enter it here.

Preferences (OPTIONAL)

Destination Luxe Travel will make the requests below at the time of booking. By entering requests, I understand that these are not guaranteed and are at the discretion of the operato unless I have specifically purchased seating or a hotel room type is specifically indicated in my quote.

Airline Seat Preference

Hotel Preferences

Hotel Accommodation Preferences

Frequent Flier and Loyalty Programs

If you are a member of an airline or hotel rewards program, please enter the program name and your membership number below so that you may accumulate miles or rewards points for applicable travel booked through Destination Luxe Travel. Mileage and rewards are not guaranteed.

Program Name(s) and Membership Number(s)

U.S. Department of Transportation Prohibition of Hazardous Materials on Airplanes

Federal law forbids the carriage of certain hazardous materials, such as aerosols, fireworks, and flammable liquids, aboard the aircraft. If you do not understand these restrictions, go to http://www.faa.gov/about/initiatives/hazmat_safety.

Acknowledgement of Prohibition of Hazardous Materials on Airplanes *

I have read and affirmatively agree to understanding federal hazardous materials restrictions.

Important Liability and Waiver Information

Please review the follow and select "I agree" before submitting this form.

I hereby acknowledge that the information above is accurate. I understand and will assume any fees imposed by any operator should the above personal and passport information be submitted incorrectly. Destination Luxe Travel is not financially liable or responsible for reservations made based on inaccuracies submitted by travelers on this form. *

I agree

Signature *

Clear

By submitting this form, I acknowledge that Destination Luxe Travel offers retail travel services to customers, which are provided by separate and independent vendors of travel services. Destination Luxe Travel does not operate, control, or otherwise provide the services of the independent travel vendors. Hence, customer agrees that Destination Luxe Travel acts only as agent for the client in acquiring transportation, hotel accommodations, sightseeing and other privileges, or services for the clients’ benefit, and on the express condition that Destination Luxe Travel shall not be responsible for any loss, accident, injury, delay, defect, omission or irregularity which may occur or be occasioned, whether by reason of any act, negligence or default of any company or person engaged in or responsible for carrying out any of the arrangements, or otherwise in connection therewith.

Client Profile

The following Client Profile form is to be used as instructed by your agent.

This form is for clients who have already received a proposal from Destination Luxe Travel and are working with one of our agents.

Passport Information:

Preferences (OPTIONAL)

Frequent Flier and Loyalty Programs

U.S. Department of Transportation Prohibition of Hazardous Materials on Airplanes

Important Liability and Waiver Information