Na'Koie Wilbon Birthday

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2019 Na'Koie Wilbon Birthday Celebration Cruise Registration Form

Mexican Riviera Cruise Carnival Splendor April 13-20, 2019
Na'Koie Wilbon is cruising the Mexican Riviera, April 13-20, 2019 on the Carnival Splendor!

Na'Koie Wilbon would like to personally invite you to cruise with her in 2019 to celeberate her special day. The cruise features 4 NEW ports – Los Angeles (Long Beach), California, Cabo San Lucas, Mazatlán and Puerto Vallarta, Mexico! Cabo San Lucas and Puerto Vallarta feature extended hours in port, allowing you to relax and enjoy longer experiences in these all new ports! Plus, celebrate Na'Koie Wilbon's Birthday while we cruise the Mexican Riviera!

Reserve YOUR Cabin Today!

(Low $25 deposit)

NO PASSPORTS NEEDED!

CRUISE ITINERARY

Day 1 - Saturday, April 13th, 2019
- Depart Los Angeles (Long Beach), CA at 4:00 PM
Day 2 - Sunday, April 14th, 2019
- Fun Day At Sea
Day 3 - Monday, April 15th, 2019
- Cabo San Lucas, Mexico 10:00 AM- 07:00 PM
Day 4 - Tuesday, April 16th, 2019
- Mazatlan, Mexico 08:00 AM- 05:00 PM
Day 5 - Wednesday, April 17th, 2019
- Puerto Vallarta, Mexico 09:00 AM- 09:00 PM
Day 6 - Thursday, April 18th, 2019
- Fun Day At Sea
Day 7 - Friday, April 19th, 2019
- Fun Day At Sea
Day 8 - Saturday, April 20th, 2019
- Los Angeles (Long Beach), CA 09:00 AM
++++Itinerary Is Subject to Change+++++

INCLUDED
- Your choice of cabin
  All inclusive food, juice, coffee, & tea
  Eight days, 7 Nights on board the Carnival Splendor
  All meals onboard, including room service
  Onboard entertainment, including shows, comedy clubs, discos, bars
  Use of pools, hot tubs, fitness facilities, etc.
  All Taxes, Fees and Port Charges
NOT INCLUDED
- Airfare and transfers to the ship
  Overnight parking at the Port
  Mandatory Gratuities of $90.65 per person
  Casino & Gambling
  Shore Excursions and Sightseeing - Book early!
  Spa and salon services
  Items of a personal nature
  Travel Insurance (recommended)
  Specialty Dining Options
AMENITIES (if 5+ cabins booked)

Guests will receive:
- Bon Voyage Champagne and Chocolates.
- $25/stateroom Credit.
- Carnival Tote Bag.
PRICES (rates subject to change if cabin not reserved by Nov. 12th, 2018)

Room Rates: TOTAL CABIN RATES (includes port charges, all inclusive food, juice, coffee, tea, & taxes)

Interior: $772.52 per person

Ocean View: $882.52 per person

Balcony: $1,102.52 per person

*Based upon double occupancy*

Please contact for single occupancy rates.

Up to 4 guests per cabin.

DEPOSIT/DUE DATES
- Due Immediately--$25/person
- Nov. 1st, 2018---$250.00/Person--Will Receive Cabin Number
- January 15th, 2019--Full Payment
BEST RATE GUARANTEE

If You find a better rate, Just Let Us Know & We Will Match It GUARANTEED! (The Cruise Must Include All Amenties Listed to Qualify for Price Match)

NOTE: Passports ARE NOT required for this sailing but are recommended. Birth Certificate & Picture ID will be needed.

1 Form Per Guest Room Only!
Guest Information

Following information is to be filled out based on those in your cabin ONLY
NOTE: It is important that guest's full name on the cruise ticket be the same as the guest's non-expired government-issued photo ID they plan to use for travel identification.

Guest # 1
Full Name

First Name Last Name

Billing Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number
Date Of Birth

- Month - Day Year
E-mail
Emergency Contact Name
Emergency Contact Number

- Area Code Phone Number
VIFP Numbers (Past Carnival Guest)
Active or Retired Military?
Full-time Interline Employee?
Senior-55 Years or Older?
U.S. Citizen & Resident? If no, Country of Citizenship?

Guest # 2
Full Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number
Date Of Birth

- Month - Day Year
E-mail
Emergency Contact Name
Emergency Contact Number

- Area Code Phone Number
VIFP Number (Past Carnival Guest)
Active or Retired Military?
Full-time Interline Employee?
Senior-55 Years or Older?
U.S. Citizen & Resident? If no, Country of Citizenship?

Guest #3
Full Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number
Date Of Birth

- Month - Day Year
E-mail
example@example.com
Emergency Contact Name
Emergency Contact Number

- Area Code Phone Number
VIFP Number (Past Carnival Guest)
Active or Retired Military?
Full-time Interline Employee?
Senior-55 Years or Older?
U.S. Citizen & Resident? If no, Country of Citizenship?

Guest #4
Full Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number
Date Of Birth

- Month - Day Year
E-mail
example@example.com
Emergency Contact Name
Emergency Contact Number

- Area Code Phone Number
VIFP Number (Past Carnival Guest)
Active or Retired Military?
Full-time Interline Employee?
Senior-55 Years or Older?
U.S. Citizen & Resident? If no, Country of Citizenship?

Special Requests:

Dining Preference?

Early (6pm) Late (8:15pm) Anytime (5:45pm-9:30pm)

Special Needs: Do you have any special needs including Pregnancy?

Yes No
If yes, please describe below: (i.e., Medical, Dietary, Limited Mobility, Allergic Reactions, Cabin Assignment Requests, Comments)?
If pregnant, will enter the 24th week of estimated fetal gestational age before or at any time during the cruise?

Yes No

Cabin Type

Inside Cabin- $772.52pp Oceanview- $882.52pp Balcony-$1,102.52pp

Do you need the following?

Cruise Protection Plan $109.00 pp Pre-Paid Gratuities-$90.65 pp

Would you like transfers to/from port?

Yes No

YOUR AGREEMENT WITH EMPIRE DYNASTY TRAVEL

Before we make arrangements for your flight, hotel, car rental, tour, cruise, or other trip, we require that you sign this form; your signature will signify your agreement with the following terms and conditions:

Empire Dynasty Travel acts as a sales agent for any airline, hotel, car-rental company, tour operator, cruise line, or other service provider named in your itinerary (“Suppliers”). Empire Dynasty Travel is not responsible for acts or omissions of the Suppliers or their failure to provide services or adhere to their own schedules.

Empire Dynasty Travel assumes no responsibility for and shall not be liable for any refund, personal injury, property damage, or other loss, accident, delay, inconvenience, or irregularity which may be caused by: (1) any defaults, wrongful or negligent acts, or omissions of the Suppliers; (2) any defect in or failure of any vehicle, craft, equipment, or instrumentality owned, operated, or otherwise used or provided by the Suppliers; or (3) any wrongful or negligent acts or omissions on the part of any other party not under Empire Dynasty Travel control. You hereby release Empire Dynasty Travel from all claims arising out of any problem covered in this paragraph.

You acknowledge and understand that cruise lines, tour operators, and other Suppliers have their own contracts covering cancellation penalties and other terms and conditions, and that you may be bound by those contracts regardless of whether you receive notice of their terms.

Empire Dynasty Travel has no special knowledge regarding the financial condition of the Suppliers, unsafe conditions, health hazards, weather hazards, or climate extremes at locations to which you may travel. For information concerning possible dangers at destinations, Empire Dynasty Travel recommends contacting the Travel Warnings Section of the U.S. State Department at (202) 647-5225 or www.travel.state.gov. For medical information, Empire Dynasty Travel recommends contacting the Centers for Disease Control at (877) FYI-TRIP or www.cdc.gov/travel. You assume full and complete responsibility for checking and verifying any and all passport, visa, vaccination, or other entry requirements of your destination(s), and all conditions regarding health, safety, security, political stability, and labor or civil unrest at such destination(s). You hereby release Empire Dynasty Travel from all claims arising out of any problem covered in this paragraph. You agree that the courts in Jackson County will be the exclusive jurisdiction for all claims brought by you or Empire Dynasty Travel, and you hereby submit to the personal jurisdiction of those courts.

For your protection, we strongly recommend that you purchase trip travel insurance. We also strongly recommend that you use a credit card for your purchase, so that you can exercise your rights under the Fair Credit Billing Act if you do not receive the services you purchased.

Cruise Deposit

Double Deposit $ 51.80

Triple Deposit $ 77.55

Quad Deposit $ 103.30

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Billing Postal Code

Signature

Clear

A Wave invoice will be emailed to all guest to make payments. Please be advised the entire balance will reflect on your invoice. You may select the "edit" button to make desired payment.

Travel Agent Information:

Empire Dynasty Travel

Contact: Kim

Hours: M-F 12pm, CST-5pm, CST

Phone :(816) 476-7805 Fax :(816) 796-6935 Email : empiredynastytravel@gmail.com

Website : www.empiredynastytravel.com

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2019 Na'Koie Wilbon Birthday Celebration Cruise Registration Form

Guest Information

Guest # 2

Guest #3

Guest #4