Client Information

Please complete all fields accurately. Contact us with any questions.

Your Name

Prefix First Middle Last Suffix

Please list full legal name as it appears on government issued ID

Date of Birth*

State of Residence*

Known Traveler Number (KTN)

Enter KTN if applicable

Loyalty Numbers

Please enter any loyalty/rewards numbers to include airline, cruise lines, hotels, etc. Be sure to specify the name of the supplier before each number listed.

Your Email Address*

Email Address Confirm Email Address

Check this box if you would like to join our mailing list

Join e-mail list

Your Phone*

Your Address

Street Address Address Line 2 City State ZIP Code

Additional Traveler 1

Prefix First Middle Last Suffix

Please list full legal name as it appears on government issued ID

Date of Birth

State of Residence

Different address?

Yes
No

Your Email Address

Email Address Confirm Email Address

Check this box if you would like to join our mailing list

Join e-mail list

Your Phone

Known Traveler Number (KTN)

Enter KTN if applicable

Loyalty Numbers

Please enter any loyalty/rewards numbers to include airline, cruise lines, hotels, etc. Be sure to specify the name of the supplier before each number listed.

Additional Traveler 1 Address

Street Address Address Line 2 City State ZIP Code

Would you like to add another traveler?

Additional Traveler 2

Prefix First Middle Last Suffix

Please list full legal name as it appears on government issued ID

Date of Birth

State of Residence

Different Address?

Yes
No

Email Address

Email Address Confirm Email Address

Check this box if you would like to join our mailing list

Join e-mail list

Phone

Additional Traveler 2 Address

Street Address Address Line 2 City State ZIP Code

Known Traveler Number (KTN)

Enter KTN if applicable

Loyalty Numbers

Please enter any loyalty/rewards numbers to include airline, cruise lines, hotels, etc. Be sure to specify the name of the supplier before each number listed.

Would you like to add another traveler?

Additional Traveler 3

Prefix First Middle Last Suffix

Please list full legal name as it appears on government issued ID

Date of Birth

State of Residence

Different Address?

Yes
No

Email Address

Email Address Confirm Email Address

Check this box if you would like to join our mailing list

Join e-mail list

Phone

Additional Traveler 3 Address

Street Address Address Line 2 City State ZIP Code

Known Traveler Number (KTN)

Enter KTN if applicable

Loyalty Numbers

Please enter any loyalty/rewards numbers to include airline, cruise lines, hotels, etc. Be sure to specify the name of the supplier before each number listed.

Would you like to add another traveler?

Additional Traveler 4

Prefix First Middle Last Suffix

Please list full legal name as it appears on government issued ID

Date of Birth

State of Residence

Different Address?

Yes
No

Email Address

Email Address Confirm Email Address

Check this box if you would like to join our mailing list

Join e-mail list

Phone

Additional Traveler 4 Address

Street Address Address Line 2 City State ZIP Code

Known Traveler Number (KTN)

Enter KTN if applicable

Loyalty Numbers

Please enter any loyalty/rewards numbers to include airline, cruise lines, hotels, etc. Be sure to specify the name of the supplier before each number listed.

Contact Information

Please provide the best way for us to communicate with you about your travel. This information will also be provided to travel suppliers should they need to contact you about your trip.

Preferred Method of Contact

Best Time to Call You

Additional Comments and Preferences

Please list any special accommodations or preferences. This includes dietary restrictions, food allergies, etc. You can also provide bedding configurations, requested dining time, special occasions, or other preferences and requests.

Your Comments/Questions

Consent*

I agree for the provided information to be used to book my travel and other add-ons.

By submitting this form you agree that the information provided is accurate and will be used to book your travel. Incorrect information may result in being denied boarding on flights or cruises or admittance to other bookings. You agree to review all documents provided by the agency and are responsible for verifying the information and packages are correct. You must notify Seas the Shores Travel, LLC immediately of any discrepancy found.