1-888-384-2669
514-344-8888

Dance cruise registration form

Please click “Submit” below to submit your registration form by e-mail or click “Download” to save, print and mail or fax a copy. You can also call us – 514-497-1960 or 1-888-384-2669 – to reserve and book your spot.

PERSONAL INFORMATION

(As it appears on your passport where applicable)

First Name (required)
Middle Name or initial
Last Name (required)

Mailing Address Street Number and Name (required)
Apt. #
City (required)

State or Province (required)
Country (required)
Zip or Postal Code (required)

Home Telephone (required)
Cell or Work Telephone
Email Address

Name (as you would like it to appear on your badge)

Date of Birth
Citizenship

MaleFemale

Passport #
Date Issued
Expiry Date
Place Issued

Past cruiser with this cruise line?
YesNo
Past Cruiser Number (With this cruise line)

Emergency Contact Name for Cruise Ship (Not sailing with you)
Relationship

Emergency Contact telephone
Alternate Telephone Number

PAYMENT INFORMATION

Type of Credit Card
VISAMasterCardAmerican ExpressOther
Name as it appears on Credit Card

Last 4 numbers on the Credit Card
Expiration date
3 digit CVC Code on back or
4 digit on the front for AMEX
Billing Address (If different than your mailing address)
Zip or Postal code

PREFERRED CABIN

Type
Inside CabinOcean ViewPrivate BalconyPrivate Suite

Occupancy
Single OccupancyDouble OccupancyTriple Occupancy

REFERRAL INFORMATION

How did you hear about this cruise?

If you were referred through the Internet, please list the site:

If you were referred by someone, who referred you?

Today’s Date (required)