Wilkins Tour Registration Form

DEPOSIT IS REQUIRED
$520 PER PERSON ONLINE -OR- $500 PER PERSON BY CHECK
Please enter your name and information exactly as it appears in your passport.
YOU ARE NOT CONFIRMED ON THE TOUR UNTIL WE RECEIVE YOUR DEPOSIT
Please register once per person
Make checks payable to Gomega Travel
MAIL TO: Gomega Travel, 2441 High Timbers, Suite 310, The Woodlands, TX 77380
Email: bev@gomegatravel.com
Phone:(281)363-3659, 800-363-0012, Fax:(281)298-7322
To pre-register for a travel tour, please complete the registration form below and hit Submit. For more information and rates please review our Travel Insurance page.

Fields marked with an * are required for submission.

    Tour Name *

    Room Type *

    Double FullDouble Land OnlySingle FullSingle Land Only

    Jordan Extension?

    YesNo

    Your Full Name *

    Title

    NickName(for nametag)

    Spouse's First Name(if traveling)

    Spouse's Title

    Spouse's Nick Name

    Email *

    Telephone*

    Mobile Phone

    Address *

    City *

    State *

    Zip *

    Pastor or Tour Leader

    Smoking preference

    SmokingNon-Smoking

    Type of Accomodation

    SingleRoomate

    Roommate Name

    Need a Roommate?

    YesNo

    Departure Date *

    Departure City *

    Passport Number

    Date of issue

    Expiration Date

    Country

    Date of Birth*

    Emergency Contact Name

    (Not travel companion)

    Relationship

    Emergency Phone

    Frequent Flyer Number

    Freq. Flyer Airline

    Seating Preference**

    AisleWindowCenterBulkheadExit Row

    Special meal Request **

     

    Yes

     

    Security Code:

    captcha

    Verify Code:

     

    ** Disclaimer: Gomega Travel will make a request, however, we cannot guarantee that your request will be honored by the airline.