Register for Your Trip | MoonLight Cruises and Vacations

Enter Your Cruise or Land Vacation Name & Date:

Referred By?

Passenger Information

Salutation

Mr.

Mrs.

Ms.

Rev.

Dr.

First Name

- Your Legal Name as Listed on Driver's License or Birth Certificate

Last Name

Address

City

State

Zip

Birthday

US Citizen

YES

NO, I am a citizen of

Phone (H)

Phone (W)

EMAIL:

Roommates: Please list the guests that are sharing a room with you.

Roommate 1:	Date of Birth
Roommate 2:	Date of Birth
Roommate 3:	Date of Birth

Friends & Family: List them here to help us with dining and room assignments.

Friends & Family Traveling With You:
Not traveling with anyone. Going because of the date & group rates check here.

TRIP/ VACATION INFORMATION

You will be notified by email or phone if your selection is no longer available.

SELECT ONE:	Vacation Type	Cruise or Air/Hotel or Air/Hotel/Meals(All-inclusive)
	Room Type
	Price	$Per Person

PAYMENT SECTION

PAY BY Credit/Debit Card:

Payment Type:		Payment Amount $
Cardholder Name:
Card Number:	Expiration Date (mm/yy): Payment will be billed as Moonlight Cruises on your credit or debit card.

Card Verification #
See Images Below For Explanation On Where Your Verification Number is Listed -->

YOUR CARD VERIFICATION NUMBER IS YOUR ADDITIONAL PROTECTION -- to ensure your credit card information is not being used fraudulently. Your IP Address is also recorded for security reasons.

Please Read the Terms and Conditions:
Your Cabin will not be Reserved until we receive if you do not accept these terms.

Terms and Conditions:I acknowledge that I have read this registration form completely and the information I provided is accurate.I understand that my deposit is non-refundable and other cancellation penalties will apply depending on the cancel date. I understand that if my roommate(s) cancel, my rate will change. I understand that ALL monies must be paid by the final payment date. If my balance is left unpaid, my cabin will be cancelled within 5 business days after the final payment date. A reservation reinstatement fee will be charged if space is still available. Prices for reinstated cabins may be higher than the initial rate. A $50 per person administration fee will be charge by our agency, regardless to the cancel date. Return check fee is $25.

I AGREE

If you disagree, we cannot accept your registration.