Guest Information Form

Page 1

Travel Agency (If Applicable)

Departure Date

Reservation ID

(Seven-digit number beginning with number one)

Vessel

First Name

Middle Name

Last Name

Title (Mr, Mrs, Ms, Etc.)

Citizenship

Type of ID

ID Number

Place of Issue

Date of Issue

Expiration Date (Enter 1/1/2099 for IDs without expiration date)

Date of Birth

Birthplace Country

Birthplace State or Province

Birthplace City

Country of Residence

Mailing Address

City

State or Province

Zip or Postal Code

Cell Phone

Home Phone

Business Phone

Emergency Contact

Emergency Contact Phone

Will you be celebrating a special occasion with us? Please specify if for a specific guest and the date and nature of the celebration.

Do you have any mobility issues or health concerns we should be aware of? If yes, please indicate if for a specific guest.

Do you have any special dietary needs*? If yes, please indicate if for a specific guest.

Do you have information to submit for additional guest(s) under the same booking number?

YesNo

By clicking Submit, I hereby:

Agree and Consent to the Ticket Contract, AQV Health & Safety / Covid Policy and Privacy Policy as issued by American Queen Voyages

Page 2

Travel Agency

First Name

Middle Name

Last Name

Title (Mr, Mrs, Ms, Etc.)

Citizenship

Type of ID

ID Number

Place of Issue

Date of Issue

Expiration Date (Enter 1/1/2099 for IDs without expiration date)

Date of Birth

Birthplace Country

Birthplace State or Province

Birthplace City

Country of Residence

Mailing Address

City

State or Province

Zip or Postal Code

Cell Phone

Home Phone

Business Phone

Emergency Contact

Emergency Contact Phone

Are you travelling with other parties? if yes, please provide their legal names or reservation number

By clicking Submit, I hereby:

Agree and Consent to the Ticket Contract, AQV Health & Safety / Covid Policy and Privacy Policy as issued by American Queen Voyages

Contact Information