“Quilt Canada” Maritime Quilt Tour
Reservation and Payment Form
June 1, 2023 – June 12th, 2023
12 Days, 11 nights
Land package only – $3795 Cdn per person – Double Occupancy
Single supplement – $1095 Cdn per person
Trip starts & ends in Moncton, New Brunswick
Price is in CDN $ Taxes Included
Reservations – Please print clearly
Preferred name for name tag_______________________________ Birth Date______________________
City _____________ Prov./State_________________ Postal/Zip Code __
Telephone ( ) ___________ Email _____________________________
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 occupancy is $1095)
Other than your roommate, will you be travelling 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 – January 27th, 2023 $1500.00
Final Payment due – March 31st, 2023
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 in & 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, ____________________________, understand that I am solely responsible for my own
belongings, safety and behavior and I do not hold Quilt Tours International and their tour representatives
liable for any injuries, losses or damages incurred on the tour.
Signed _________________________________ Date_____________________________
Cancellation Policy: All cancellations must be received in writing to Quilt Tours International or
email@example.com by the dates indicated below. A reason for the cancellation must be
Cancellation Fees: 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 travelling.
Please do not book any air travel until this tour has been confirmed