Tour Registration Form

Tour Registration Form

Vermont's Green Mountain Tours LLC
P.O. Box 2021, Georgia, Vermont 05468
Phone: (802) 527-0496 or (800) 877-4311
Fax: (802) 527-0496

* Tour that I'd like to make a reservation for:

* First Name

* Last Name

Email Address

*Home Phone Number

Cell Phone Number

*Mailing address

Address Line 2

*City

*State/Province/Region

*Zip/Postal Code

Country

NOTE: Green Mountain Tours accepts CHECKS, VISA, MASTERCARD, DISCOVER, DINERS CLUB, JCB, and UNION PAY.

* Payment Type

Name on Card

Credit Card Number

Expiration Date (mm/dd/yyyy)

Authorized by:

Date

Total:

Health Condition

Do you have allergies, or require any special medication?

Yes

No

If YES, please specify:

*Do you require special care and/or assistance?

Yes

No

If YES, please explain:

Additional Information

Share room with: (please complete separate registration form for each participant)

Partner Seating With at Show: (please complete separate registration form for each participant)

Room Type:

Smoking

Non-Smoking

TRIP CANCELLATION INSURANCE: THIS IS STRONGLY RECOMMENDED IN THE EVENT YOU MUST CANCEL YOUR TRIP DUE TO ILLNESS. To acquire this insurance call 1-800-228-9792.

Would you like to get the insurance?

Yes

No

In Case of an Emergency, Notify:

*First Name

*Last Name

Email Address

*Street Address

Address Line 2

* City

* State/Province/Region

*Zip/Postal Code

*Phone Number

Country

PICK UP POINT: Where would you like to meet the bus?
NOT ALL DEPARTURE POINTS ARE INCLUDED ON EVERY TOUR.

Please select from the list below:

* Indicates Response Required