"The Essence of Burgundy and Provence"
Reservation Request Form
Full, Legal Name(s) as it appears on a valid U.S. Passport is required
*
Indicates required field
Primary Contact Name
*
First
Last
Phone #
*
Email
*
Street Address
*
City
*
State
*
Zip
*
Passenger 1 Full, Legal Name
*
Passenger 1 Date of Birth
*
Passenger 2 Full, Legal Name
*
Passenger 2 Date of Birth
*
Stateroom Type Desired
*
Category S - Suite
Category A - French Balcony
Category B - French Balcony
Category C - French Balcony
Category D - Picture Windows
Category E - Picture Windows
Select One
Stateroom Occupancy
*
Double Occupancy
Single Occupancy
Would you like us to assist in your air transportation arrangements?
*
Yes
No
If "Yes", from what airport?
*
Special Requests or Comments
*
THIS CRUISE REQUIRES A $400 PER PERSON DEPOSIT AT THE TIME OF
BOOKING IN ORDER TO CONFIRM YOUR RESERVATION. UPON RECEIPT $200 PER PERSON IS IMMEDIATELY
NON-REFUNDABLE, AS PER AMA WATERWAYS CANCELLATION GUIDELINES.
ONCE THIS FORM HAS BEEN RECEIVED WE WILL CONTACT YOU TO GO OVER ALL DETAILS.
Name as it appears on your credit card
*
Credit Card Number
*
Expiration Date
*
Security Code
*
Submit
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