Client/Passenger Registration Form

Client/Passenger Registration Form
Please complete the following registration form. Your Name Must be Written/Spelled EXACTLY As It Appears On Your Proof of Citizenship Being Used To Travel. Name Changes/Corrections in Spelling Can Result in Penalties From The Air Line and/or Vendor. Incorrect or Incomplete Information May Lead to Denied Boarding.

For More Information About Secure Flight Program: http://www.tsa.gov/stakeholders/secure-flight-program
By providing this information, I authorize my travel agent to accept the travel supplier contract/terms and conditions on my behalf while completing the online check-in when available. (Please initial in box if you agree. Write "no" if disagree.)
Name of trip: i.e. Destination, Hotel, Ship or Tour Name, Group Name, etc.
*Please Note - You may use one form submission for up to 5 passengers in your reservation if you are family or reside at the same household. Click "Next" at bottom of 1st Passenger entry to go on to the next Passenger and so on.

**If all passengers reside in the same household, you may leave the address, phone, email and emergency contact person fields blank for passengers 2, 3, 4 and/or 5.**
1st Passenger Name (EXACTLY as Appears on Valid Passport - Including Full Middle Name or Initial if noted on Passport). If you do not have a passport at this time, list your full legal name as you are going to list it on your passport application. Most passengers list their full middle name if it is on their birth certificate. If you have any questions, inquire before completing this form.
Name on Government Issued Photo ID (For Domestic flights only)
Birth Date

MonthDayYear
Gender
E-mail
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Citizenship of
Country of Birth
Passport Number
Passport Issue Date
Passport Expiration Date
Medical Needs/Special Requests (Including pregnancy)
Emergency Contact Person's Name and Phone # (Someone NOT traveling with you.)
Cruise line past passenger / Air line frequent flyer # (s): (Indicate name of air line or cruise line with the #)
Comments/Questions/Notes:
Travel Agent You're Working With:
Click on Submit Form if Finished, or Next to Add More Passengers

2nd Passenger Name (As Appears On Valid Passport)
Name on Government Issued Photo ID (for Domestic flights only)
Birth Date

MonthDayYear
Gender
E-mail
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Citizenship of
Country of Birth
Valid Passport Number
Passport Issue Date
Passport Expiration Date
Medical Needs/Special Requests (including pregnancy)
Emergency Contact Person's Name and Phone #
Cruise line past passenger / Air line frequent flyer # (s): (Indicate name of air line or cruise line with the #)
Click on Submit Form if Finished, or Next to Add More Passengers

3rd Passenger Name (As Appears on Valid Passport)
Name as appears on Government Issued Photo ID (For Domestic flights only)
Birth Date

MonthDayYear
Birth Date

MonthDayYear
Gender
Gender
E-mail
E-mail
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Citizenship
Country of Birth
Valid Passport Number
Passport Issue Date
Passport Expiration Date
Medical Needs/Special Requests (including pregnancy)
Emergency Contact Person's Name and Phone #
Cruise line past passenger / Air line frequent flyer # (s): (Indicate name of air line or cruise line with the #)
Click on Submit Form if Finished, or Next to Add More Passengers

4th Passenger Name (As Appears on Valid Passport)
Name as appears on Government Issued Photo ID (For Domestic flights only)
Birth Date

MonthDayYear
Gender
E-mail
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Citizenship
Country of Birth
Valid Passport Number
Passport Issue Date
Passport Expiration Date
Medical Needs/Special Requests (including pregnancy)
Emergency Contact Person's Name and Phone #
Cruise line past passenger / Air line frequent flyer # (s): (Indicate name of air line or cruise line with the #)
Click Submit Form if Finished, or Next to Add More Passengers

5th Passenger Name (As Appears on Valid Passport)
Name as appears on Government Issued Photo ID (For Domestic flights only)
Birth Date

MonthDayYear
Gender
E-mail
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Citizenship
Country of Birth
Valid Passport Number
Passport Issue Date
Passport Expiration Date
Medical Needs/Special Requests (including pregnancy)
Cruise line past passenger / Air line frequent flyer # (s): (Indicate name of air line or cruise line with the #)
Emergency Contact Person's Name and Phone #
Should be Empty:

Client/Passenger Registration Form

*Please Note - You may use one form submission for up to 5 passengers in your reservation if you are family or reside at the same household. Click "Next" at bottom of 1st Passenger entry to go on to the next Passenger and so on.