Bob Eubanks Registration Form

Bob Eubanks Registration Form

Join Us!

Featuring Keynote Speaker

&

Host of

The Newlywed Game!

Bob Eubanks

Along with Comedian

Rog Bates

10 Night Eastern Mediterranean Cruise on

Celebrity Equinox

Aug 3 - 13th 2012

Please open with FireFox

Required *

Your Name and Passport No Required * Your Name- First -M--Last name ( As on Passport)

Your Name- First -M--Last name ( As on Passport)

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List all Cabin mates Name(s) Birth date(s) List all Cabin mates Name(s) Birth date(s)

Street Address * your address

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E-mail address *

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City, State, Zip *

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Home Phone *

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Cell Phone *

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Any Children going on the cruise? *

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Children: Name and Birth Date List the Children: Name(s) and date of birth(s)

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Type of cabin-(inside-outside-balcony) * Size Type of room Single - Double - triple - Quad

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Birth Dates * Your date of Birth

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Captains Club Number If you have a Cruise Number or discount number - list here

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Travel Insurance(yes-no) * Do you want Travel Insurance - yes or no

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Referred by how did you hear about the cruise?

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Do you need airfare? We can get you an airfare quote

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