Company Your magical memories are just one click away! Please complete the Booking Agreement below so we can finalize your booking. We look forward to creating magic for your family! Your Pixie Dust & Pirate Hooks Travel Specialist * Alexa Ean Amy Johnson Amy Moon Ashlee Walker Brett Cossaboon Danielle Jackson Eileen Johansson Jennifer Bowman Julie Heller Kailey Ryan Kimberlie Buxton Laura Ledbetter Leigh Nelson Melissa Tilley Morgan Choate Olivia Askin Rachael Gascoigne Rebecca Berger Sam DiPace Staci Foster Stacy Moseley Stephanie Hensley Lead Guest Name * Date of Birth * Gender * Phone Number * Email Address * Address * City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Additional Guest Information - Name, Gender, & DOB * *Please make sure you list LEGAL names as reflected on passport, license or birth certificate. Please provide TSA Pre-Check / Known Traveler Numbers and any applicable rewards numbers Please provide your Travel Specialist with your chosen option details from your vacation proposal. Arrival Date * Departure Date * Vacation Details * Does anyone in your party have food allergies? * Yes No If yes, please list allergies. Please list any stateroom requests you may have. (Please note: Requests are only requests and not a guarantee.) Will you be celebrating anything during your stay? (Birthday, anniversary, etc.) Authorize Payment * This is to confirm that, in keeping with all applicable laws, I am instructing Pixie Dust & Pirate Hooks to purchase travel against the credit card listed below. Further, I understand that I have authorized this transaction and will hold Pixie Dust & Pirate Hooks harmless with respect to these instructions. Amount You Wish To Pay: * Payment Date * *Please note that you are not making a payment by submitting this form. Your Travel Specialist will process your payments for you within 24 hours of receipt. Please provide your Credit Card information below: Name as it Appears on Card * Billing Address, if different than above Credit Card Number * Expiration Date * CVC * Travel Insurance * Please quote travel insurance. I decline travel insurance for my vacation. I acknowledge that Pixie Dust & Pirate Hooks offered travel insurance. I already have travel insurance. *Please Note - Travel insurance may be added up until the time of travel, however, if you would like a "Cancel For Any Reason" policy or to cover pre-existing conditions, this must be added within 15 days of your deposit. Travel Insurance is recommended by Pixie Dust & Pirate Hooks to protect you from situations that could cause your vacation to be canceled, interrupted or delayed which could result in a loss of time and money. Please contact your Travel Specialist to discuss options and insurance providers available for your reservation(s) and pricing. (Right-click link and select open link in new window.) Cancellation Policy * I have read and understand the Cancellation Policy. Terms and Conditions * I agree to the Terms and Conditions set forth by Pixie Dust & Pirate Hooks, the supplier, hotels, cruise line, airline and/or excursion companies. *A booking confirmation and payment receipt will be emailed to you when your booking has been made and payment has been applied. Please print this page for your records.*