Southern Caribbean Cruise 2020 Registration
Sponsored by C&S Tours, LLC and Florence County Parks and Recreation
Cruise Dates: March 3-16, 2020
Contact Brenda Brown at (843) 656-2450 or bbrown@florenceco.org
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First Name *
Print first name EXACTLY as it appears on the government issued identification.
Middle Name
Print middle name EXACTLY as it appears on the government issued identification.
Last Name *
Print last name EXACTLY as it appears on the government issued identification.
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Home Address *
City, State, Zip Code *
Phone Number (Mobile) *
Phone Number #2 (Optional)
Email Address *
Cabin Type *
Required
Bed Options
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Are you a Past Guest of Holland America Line? *
Have you served in the Military? *
Active Duty, Retired military, or Veteran with an Honorable Discharge?
Dietary restrictions *
Is an ADA accessible cabin required?
Clear selection
Would you like to purchase Travel Cancellation Protection ($128pp Interior or $149pp Oceanview/Balcony)? *
Is wheelchair assistance needed at the airport?
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Please list roommate below. *
List first and last name of each roommate. If you will not have a roommate, then write NONE in the space below.
Emergency Contact's Name *
Please include first and last name of your emergency contact below.
Relationship to Passenger *
Emergency Contact's Phone Number *
Additional Comments
Please note any additional requests.
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