Passenger Name/DOB:  
Passenger Name/DOB:  
Passenger Name/DOB:  
Passenger Name/DOB:  
Preferred Agent:  
Room Occupancy: ______Single ______Double ______Triple ______Quad  
Name of Trip/Date of Trip:  
Amount Enclosed:  
Room Category: ______Garden  ______Oceanview  ______Oceanfront  ______Balcony
Cruise Cabin Category: ______Interior  ______Oceanview  ______Balcony ______Jr. Suite
Insurance/Smoking:  Insurance:  _____Yes  _____No     Smoking: _____Yes  _____No
Email Address:  
Home Phone:  
*Card # __Visa  __MC __Check:  
Security Code/Expiration  Date:  
Special Requests/Comments/Notes:  

Cancellation Policy:

Up to 121 days prior to departure:  Initial deposit

120 to 91 days prior to departure: 25% of cost

90 to 60 days prior to departure: 50% of cost

60 to 2 days prior to departure: 100% of cost

Instant Purchase Airfare or Packages

Instant Purchase Airfare: 100% of airfare

Instant Purchase Package: 100% of package

I understand that it is my responsibility to obtain the correct travel documentation (passport, visa, identification) for the destination(s) to be visited. Passport may be required and must be valid six (6) months past departure date.  I understand that the names printed on this registration must match exactly the first and last names in each passport. Any discrepancy may result in cancellation, change fees, new and higher airfares or denial of services.  I am aware that travel agent, hotel and/or air cancellation fees will apply. I have read and agree with the terms and conditions available on colesvilletravel. com website including cancellation penalties.   My payment and signature  constitute acceptance of the terms above. 
 Cardholder Signature/Date:  
Fax/mail/scan to Colesville Travel at 301-989-8473

Colesville Travel, P.O. Box 4844, Silver Spring, MD 20914. Phone: 301-989-1654. 

Email  Website:


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