Blue Travel, Inc. - RESERVATION FORM - Coral Princess Cruises Please fax to USA Toll Free: 1-877-605-6888 or United Kingdom: +44-208-711-5331 | Germany: +49-3222-690-6222 . CUSTOMER ADDRESS: (please print) : ___ Mr. ___ Mrs. . Last Name: _____________________________________________________ . First Name: _____________________________________________________ . Street: _____________________________________________________ . City: _____________________________________________________ . State, ZIP: _____________________________________________________ . Country: _____________________________________________________ . Phone Number: _____________________________________________________ . Fax Number: _____________________________________________________ . E-Mail: _____________________________________________________ . PAYMENT: Card Type: ___ MasterCard ___ VISA . Card Holder: _____________________________________________________ . Full Cardnumber: _____________________________________________________ . Expiration Date: ________________________________________ (month/year) . This is a legally binding reservation request and I authorize Blue Travel to disclose my personal information to Coral Princess Cruises. I give permission for Coral Princess Cruises to charge my credit card accordingly with the appropriate cruise costs. I acknowledge that I am the authorized card holder of this account. I have read the Terms and Conditions for the requested Coral Princess Cruise program and agree to abide by them. . RESERVATION: Cruise : ___________________________________________________________ . Start in : ___________________________________________________________ . End in : ___________________________________________________________ . Start Date: ___ / ___ / ______ (day/month/year) . Flight prior/after Cruise: ___ Cairns-Townsville ___ Townsville-Cairns . . ___ Cairns - Thursday Island ___ Thursday Island - Cairns . Category : ___________________________________________________________ . Type : ___ Twin ___ Double ___ Triple ___ Sole Use . PARTICIPANTS: Mr. Mrs. First Name Last Name . 1. ___ ___ ______________________________ _____________________________ . 2. ___ ___ ______________________________ _____________________________ . 3. ___ ___ ______________________________ _____________________________ . 4. ___ ___ ______________________________ _____________________________ . SPECIAL REQUIREMENTS: . . . . ____________________________________ ___________________________________ City and Date Signature