Guest Form (1 per cabin)  

Name: _________________________________ Birth date: _____________

Name: _________________________________ Birth date: _____________

Name: _________________________________ Birth date: _____________

Name: _________________________________ Birth date: _____________

Address: _________________________________

_________________________________

_________________________________ E-mail address__________________________________

 Phone: _________________________________ and Emergency Phone Number____________________________

Goose Years_______________ Class year________________

 Are you a US citizen: Y / N If no from what country: _____________________

Do you want: Inside or Outside or Balcony or Suite

Do you need air: Y / N From what city: _____________________________

Do you need transfer: Y / N (To get to and from ship to airport included with cruise line airfare)

Flight information: airline: ________ flight # ________ from where ________

what time is arrival _____________  (Please make flight to go home after 3:00 pm)

Airline _________ flight # ________ from where ________

What time is departure _______________

Do you want pre or post cruise hotel? Y /N  Do you want Insurance: Y / N ........Dinning Freestyle on NCL

Payment Make checks out to GoldRush Getaways

Check - #______________ amount $ ______________

Credit card #____________________________________ exp ________________

Amount $________________________

Billing address: ____________________________________________________

 ____________________________________________________

 ____________________________________________________

Print out or e-mail this to goosebrat@yahoo.com or fax to (916) 441-1544

Or send to Jerry Carroll                (916) 447-8930
4600 South Land Park Dr
Sacramento, CA. 95822