Tour Registration Form

Please complete the additional traveler’s information required for all travelers traveling to Cuba.

If your group has more than the form’s maximum of 9 travelers, you can submit the form more than once.

Booking # *

Number of Travelers *

Traveler 1

First & Middle Name *

Last Name *

Date of Birth (MM/DD/YY) *

Country of Birth *

Passport # *

Passport Country *

Passport Expiration (MM/DD/YYYY) *

Traveler Born in Cuba *

Email Address *

Phone # *

Medical Conditions we should be aware of, including disabilities, allergies,
including food and medications?

Emergency Contact Name

Emergency Contact Phone #

Traveler 2

First & Middle Name *

Last Name *

Date of Birth (MM/DD/YY) *

Country of Birth *

Passport # *

Passport Country *

Passport Expiration (MM/DD/YYYY) *

Traveler Born in Cuba *

Email Address *

Phone # *

Medical Conditions we should be aware of, including disabilities, allergies,
including food and medications?

Emergency Contact Name

Emergency Contact Phone #

Traveler 3

First & Middle Name *

Last Name *

Date of Birth (MM/DD/YY) *

Country of Birth *

Passport # *

Passport Country *

Passport Expiration (MM/DD/YYYY) *

Traveler Born in Cuba *

Email Address *

Phone # *

Medical Conditions we should be aware of, including disabilities, allergies,
including food and medications?

Emergency Contact Name

Emergency Contact Phone #

Traveler 4

First & Middle Name *

Last Name *

Date of Birth (MM/DD/YY) *

Country of Birth *

Passport # *

Passport Country *

Passport Expiration (MM/DD/YYYY) *

Traveler Born in Cuba *

Email Address *

Phone # *

Medical Conditions we should be aware of, including disabilities, allergies,
including food and medications?

Emergency Contact Name

Emergency Contact Phone #

Traveler 5

First & Middle Name *

Last Name *

Date of Birth (MM/DD/YY) *

Country of Birth *

Passport # *

Passport Country *

Passport Expiration (MM/DD/YYYY) *

Traveler Born in Cuba *

Email Address *

Phone # *

Medical Conditions we should be aware of, including disabilities, allergies,
including food and medications?

Emergency Contact Name

Emergency Contact Phone #

Traveler 6

First & Middle Name *

Last Name *

Date of Birth (MM/DD/YY) *

Country of Birth *

Passport # *

Passport Country *

Passport Expiration (MM/DD/YYYY) *

Traveler Born in Cuba *

Email Address *

Phone # *

Medical Conditions we should be aware of, including disabilities, allergies,
including food and medications?

Emergency Contact Name

Emergency Contact Phone #

Traveler 7

First & Middle Name *

Last Name *

Date of Birth (MM/DD/YY) *

Country of Birth *

Passport # *

Passport Country *

Passport Expiration (MM/DD/YYYY) *

Traveler Born in Cuba *

Email Address *

Phone # *

Medical Conditions we should be aware of, including disabilities, allergies,
including food and medications?

Emergency Contact Name

Emergency Contact Phone #

Traveler 8

First & Middle Name *

Last Name *

Date of Birth (MM/DD/YY) *

Country of Birth *

Passport # *

Passport Country *

Passport Expiration (MM/DD/YYYY) *

Traveler Born in Cuba *

Email Address *

Phone # *

Medical Conditions we should be aware of, including disabilities, allergies,
including food and medications?

Emergency Contact Name

Emergency Contact Phone #

Traveler 9

First & Middle Name *

Last Name *

Date of Birth (MM/DD/YY) *

Country of Birth *

Passport # *

Passport Country *

Passport Expiration (MM/DD/YYYY) *

Traveler Born in Cuba *

Email Address *

Phone # *

Medical Conditions we should be aware of, including disabilities, allergies,
including food and medications?

Emergency Contact Name

Emergency Contact Phone #

Tour Registration Form

Traveler 1

Traveler 2

Traveler 3

Traveler 4

Traveler 5

Traveler 6

Traveler 7

Traveler 8

Traveler 9

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