Deaf Freedom Cruise 2014 - Southern Caribbean
$250.00 per person deposit due at sign up to hold you room. Monthly Payment Plans available for new sign ups.

Sign up and deposit today...Don't miss the boat!

<"oasis submit form" target="_blank" id="group info sheet">
Deaf Freedom Cruise 2014

Sign Up Form

 

 

Your First Name (LEGAL NAME - ON PASSPORT)

Your Last Name (LEGAL NAME - ON PASSPORT)

Your Passport Country

Birth date:

Roommate's First Name (LEGAL NAME - ON PASSPORT)

Roommate's Last Name (LEGAL NAME - ON PASSPORT)

Your Roommate's Passport Country

Second Roommate's Birth date:

Adding a Third Person

Roommate's First Name (LEGAL NAME - ON PASSPORT)

Roommate's Last Name (LEGAL NAME - ON PASSPORT)

Third Roommate's Passport Country

Third Roommate's Birth date:

Adding a Fourth Person

Roommate's First Name (LEGAL NAME - ON PASSPORT)

Roommate's Last Name (LEGAL NAME - ON PASSPORT)

Fourth Roommate's Passport Country

Fourth Roommate's Birth date:

Your Address:

Street City

State Zip

Email Address

Phone Number IS this VP Number? Yes No

ROOM CHOICE

Room Category:

Interior - no window
           K     L     N

Ocean View Window
         G    H    I

Deluxe Ocean View with private Balcony
         E3   E2   E1

Superior Ocean View with private Balcony
         D2   D1

Suite with Private Balcony
         JS GS OS RS

Deck (floor)

2     3     4     7     8     9     10

Please enter the price from the price list

Please Check all that apply:

Deaf      Hard of Hearing   Hearing

Blind     Low Vision   Usher's Syndrome

Use a Wheel Chair or Scooter

Use a Walker

Have CP

I was referred by (if no referral, please leave blank):

Please Review your information to be sure it is correct.
When ready, click submit to send your information.