“Amsterdam & Belgium” Quilt Tour
Reservation and Payment Form
April 3, 2024 – April 12, 2024
10 Days, 9 Nights
Land package only -$4495 Cdn per person – Double Occupancy
Single Supplement – $1250 Cdn per person
Trip starts and ends in Amsterdam, Netherlands
Price is in CDN $ – taxes included
Reservations – Please print clearly
Name _______________________________________________________________________________ (As it appears on your passport)
Preferred name for name tag_______________________________ Birth Date______________________
City _________________________ Prov./State_________________ Postal/Zip Code ______________
Telephone ( ) _______________________ Email _________________________________________
Passport Number ________________________________ Expiry___________
Emergency Contact ____________________________________________________________________
Relationship ____________________ Emergency Phone Number ___________________________
I will be rooming with ________________________
Please help find me a roommate Y / N I would like my own room Y / N (single supplement $1250)
Other than your roommate, will you be traveling with other friends or family, please name.
Mobility issues: ______________________________________________________________________ (Are you able to walk / climb stairs unaided? Any special equipment i.e., cane, walker etc.)
Dietary or food allergies: ________________________________________________________________
Medical Issues: ________________________________________________________________________
Initial Deposit – As soon as possible to secure your spot $500.00
|Second Payment – November 1st, 2023||$1500.00|
|Final Payment due – January 3rd, 2024||$2495 Double occupancy $3745 Single supplement|
Please return the completed form
By a deposit cheque to our mailing address Quilt Tours International, 19 Hallam Road, Markham, Ontario L3P 5Y4 *Cheques to be made payable to UNIGLOBE ENTERPRISE TRAVEL LTD.
( T.I.C.O Registration#: 1810380 )
By Credit Card – if you email your registration into email@example.com & wish not to include your credit card number, you may call us with it at 416-937-6739. Please check which card, print name of the card holder and a signature is required before sending.
__ Visa ___ MasterCard
CC Number _______________________________________________ Expiry ______________
Name on Card (print) ______________________________________
Signature of cardholder * __________________________________________
*Signature is required as authorization for the processing of credit card charges
Optional Travel Insurance: Travel Insurance is highly recommended. If you reside in Ontario, travel insurance (medical and/or cancellation) can be purchased through our travel agency.
I, ________________________________________, (print name) understand that I am solely responsible for my own belongings, safety and behavior and I do not hold Quilt Tours International and/or their tour representatives liable for any injuries, losses or damages incurred on the tour. I give my permission to be photographed or video recorded for the sole purpose of the promoting and marketing of Quilt Tours International. The acceptance of these terms and conditions is acknowledged and authorized by the payment of the deposit to Quilt Tours International.
Signed _____________________________________________ Date_____________________________
Cancellation Policy: All cancellations must be received in writing to Quilt Tours International or firstname.lastname@example.org by the dates indicated below. A reason for the cancellation must be included.
90 days or more before departure: Loss of $500 per person
89 to 60 days before departure: 50% of tour fees per person
59 to 30 days before departure: 75% of tour fees per person
29 days or less before departure: 100% of tour fees per person
Should Quilt Tours International need to cancel this tour for any reason, a full refund would be issued.
Registration is taken on a first come first serve basis.
This tour is based on a minimum of 20 people traveling.
Please do not book any air travel until this tour has been confirmed