NEBRASKA FOOTBALL LEGENDS CRUISE FORM

INTERIOR CABIN

Name *

Phone *

Email Address *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Will you be travelling with others on this trip? *YesNo

If yes / Name(s) of people travelling with you

How many rooms do you need? *Most rooms sleep up to 4 guests0 / 2

How many guests in your room? *Most rooms sleep up to 4 guests0 / 2

I Need Handicap Accessible room *YesNo

Name (as it appears on Credit Card) *

credit card number *

Exp. Month *month0 / 2

Exp. Year *year0 / 2

CVV# (Visa & M.C. 3 numbers on back of Card Amex 4 numbers on front) *CVV0 / 4

Would you like us to Quote you Medical Insurance Coverage? (please include your age as of day of departure) *YesNo

please include your age as of day of departure0 / 2

How did you find out about this trip? *