Hurtigruten Guest Services Form

Please note passengers will be denied boarding if form is not completed and received 70 days prior to departure with Final Payment.

* Required Fields

Today's Date: 7/30/2010
DOB*:
Booking Number:
Voyage Date*:
Last Name*:
First Name*:
Street Address*:
City*:
State/Province:
Zip Code*:
Email Address:
Phone number*:
Emergency Contact Name*:
Emergency Contact Phone Number*:
Secondary Emergency Contact Name*:
Secondary Emergency Phone Number*:
Sex*: Male  Female
Dietary Info/Allergies:
Passport Issue Date*:
Passport valid until*:
Passport Number*:
Nationality*:
Was your medical form completed and signed by a physician*: Yes  No
Cruise only: Yes  No
Jacket size: S  M  L  XL  XXL
Did you book your international air with Hurtigruten?* Yes  No
Did you book your international air independently?* Yes  No
Arrival City:
Departure City:
Arrival Date:
Departure Date:
Arrival Time:
Departure Time:
Arrival Flight:
Departure Flight:
Date(s) of hotel stay:
Do you need extra nights? Yes  No
If so what dates:
Would you like to receive information about new products and specials from Hurtigruten? Yes  No

Transfers are included for all guests unless their personal air itinerary deviates from the official Hurtigruten cruise itinerary.
BROCHURES
Hurtigruten
405 Park Avenue, Suite 904
New York, NY 10022
Tel: 866.552.0371
Fax: 212.319.1390
Email: retailsales@hurtigruten.us
Hours:
Mon-Fri: 9am-9pm EST
Sat: 10am-4pm EST
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