Trip Reservation Form
Enter your information below to request reservations for a cruise or tour.
General Information We Need to Know About You
First Name: 
Last Name:
Mailing Address:
City:
State:
Zip Code:
Country:
e-Mail:
(PLEASE verify your email address is correct)
HOME Phone:   
Work Phone:  
Date of Birth: Month Day   Year:

Do you have a Passport?
(if applicable)

YES NO NOTE: (Please be sure and check that your passport is current AT LEAST 6 MONTHS  after the end date of the trip. If it expires sooner, you must get it renewed.)
Enter Name AS IT APPEARS on your Passport: First Name: Last Name:
Additional Traveling Companions?
Yes? Enter Names separated by commas:
Emergency Contact Information:
Enter Name, Relation and Telephone Number of Emergency Contact:
 Name: Relation: Phone:
Meals, Mobility and Marketing

Do you have any dietary restrictions or needs we need to know about?

Do you have any mobility limitations we need to know about?

How did you hear about QueensLander?


I have read the Terms & Conditions  
YES NO
Which tour or cruise are you requesting a reservation for, if you want to share a room:
 
Name of Tour or Cruise:
Trip Departure Date:

Do you want to share a room on this trip? Yes No (choose only one)
     If yes, do you want to room with a friend? 
     What is their name:

 
 
Prices posted on our website are our Cash Discounted prices. Credit card payments incur a 3.5% additional charge.

Paying by Credit Card? Please complete this form and you will be contacted by reservations for secure processing.

If writing a check, make it payable to: QueensLander Tours

Mail to: QueensLander Tours
               Write Name of Travel Event Here
               3222 Green Haven Circle
               Highlands Ranch, CO 80126      

Or Fax to: 1-877-865-6711

Have Questions?     Call toll free 1-877-865-6711 in US
                                         1-720-371-2704 outside US
Is there anything else we need to know?

You will receive a confirmation once your tour space is received and space is reserved.