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Your Name Mr. Mrs. Miss Ms. Address1 Address2 City State Zip Providence/Country Daytime Phone Evening Phone E-Mail Address Verify your e-mail address Are you a past Adventures by Disney Guest? Yes No If yes, to which destination did you travel?
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List Proper Names and Ages of Children at the time of travel (No nicknames)
ADVENTURE DESTINATION AND DATES Please choose your Adventure Destination and Vacation Date Africa, Asia, Australia & Pacific Adventures More information Australia Please Select Jun 19 - Jun 30, 2013 Jul 10 -Jul 21, 2013 Aug 7 - Aug 18, 2013 Oct 23 - Nov 3, 2013 (Adults Only) Dec 18 - Dec 29, 2013 Dec 21, 2013 - Jan 1, 2014 China Please Select May 12 - May 23, 2013 (Adult Exclusive) Jun 2 - Jun 13, 2013 Jun 16 - Jun 27, 2013 Jun 23 - Jul 4, 2013 Jul 7 - Jul 18, 2013 Jul 14 - Jul 25, 2013 Jul 28 - Aug 8, 2013 Aug 4 - Aug 15, 2013 Aug 11 - Aug 22, 2013 Sep 15 - Sep 26, 2013 (Adult Exclusive) Oct 13 - Oct 24, 2013 (Adult Exclusive) Cambodia, Vietnam and Loas Please Select May 6 - May 17, 2013 (Adult Exclusive) June 10 - June 21, 2013 June 24 - July 5, 2013 July 8 - July 19, 2013 July 22 - August 2, 2013 August 5 - August 16, 2013 October 7 - October 18, 2013 (Adult Exclusive) December 23 - January 3, 2014 January 13 - January 24, 2014 (Adult Exclusive) April 14 - April 25, 2014 Egypt Please Select Apr 21 - Apr 30, 2013 May 19 - May 28, 2013 Jun 9 - Jun 18, 2013 Jun 23 - Jul 2, 2013 Jun 30 - Jul 9, 2013 Jul 7 - Jul 16, 2013 Jul 21 - Jul 30, 2013 Aug 4 - Aug 13, 2013 Sep 22 - Oct 1, 2013 Oct 20 - Oct 29, 2013 (Adult Exclusive) Nov 17 - Nov 26, 2013 Dec 22 - Dec 31, 2013 Dec 29, 2013 - Jan 7, 2014 Feb 16 - Feb 25, 2014 Mar 23 - Apr 1, 2014 Apr 13 - Apr 22, 2014 South Africa Please Select Jun 16 - Jun 25, 2013 Jun 30 - Jul 9, 2013 Jul 14 - Jul 23, 2013 Aug 11 - Aug 20, 2013 Dec 18 - Dec 27, 2013 Dec 23, 2013 - Jan 1, 2014 Feb 16 - Feb 25, 2014
Central & South America Adventures More information Eastern Costa Rica Please Select Jun 8 - Jun 14, 2013 Jun 15 - Jun 21, 2013 Jun 29 - Jul 5, 2013 Jul 6 - Jul 12, 2013 Jul 13 - Jul 19, 2013 Jul 20 - Jul 26, 2013 Aug 3 - Aug 9, 2013 Aug 10 - Aug 16, 2013 Sep 14 - Sep 20, 2013 Nov 16 - Nov 22, 2013 Dec 8 - Dec 14, 2013 Dec 21 - Dec 27, 2013 Feb 1 - Feb 7, 2014 Feb 15 - Feb 21, 2014 Mar 15 - Mar 21, 2014 Mar 29 - Apr 4, 2014 Ecuador & The Galapagos Islands Please Select Apr 10 - Apr 18, 2013 Jun 19 - Jun 27, 2013 Jul 3 - Jul 11, 2013 Jul 17 - Jul 25, 2013 Aug 14 - Aug 22, 2013 Dec 18 - Dec 26, 2013 Galapagos Islands Cruise Please Select Jul 26 - Aug 4, 2013 Dec 27, 2013 - Jan 5, 2014 Peru Please Select Jun 12 - Jun 20, 2013 Jun 23 - Jul 1, 2013 Jul 5 - Jul 13, 2013 Jul 14 - Jul 22, 2013 Jul 25 - Aug 2, 2013 Aug 4 - Aug 12, 2013 Aug 14 - Aug 22, 2013 Sep 15 - Sep 23, 2013 (Adult Exclusive) Oct 5 - Oct 13, 2013 (Adult Exclusive) Dec 20 - Dec 28, 2013
North America Adventures More information Alaska Please Select Jun 22- Jun 29, 2013 Jun 29 - Jul 6, 2013 Jul 3 - Jul 10, 2013 Jul 10 - Jul 17, 2013 Jul 13 - Jul 20, 2013 Jul 20 - Jul 27, 2013 Jul 24 - Jul 31, 2013 Aug 3 - Aug 10, 2013 Aug 14 - Aug 21, 2013 Aug 24 - Aug 31, 2013 (Adult Exclusive) Arizona and Utah Please Select May 22 - May 29, 2013 (Adult Exclusive) May 29 - Jun 5, 2013 Jun 5 - Jun 12, 2013 Jun 26 - Jul 3, 2013 Jul 3 - Jul 10, 2013 Jul 10 - Jul 17, 2013 Jul 17 - Jul 24, 2013 Jul 24 - Jul 31, 2013 Jul 31 - Aug 7, 2013 Aug 7 - Aug 14, 2013 Aug 14 - Aug 21, 2013 Aug 21 - Aug 28, 2013 Aug 28 - Sep 4, 2013 (Adult Exclusive) Montana and Alberta, Canada Please Select Jun 10 - Jun 16, 2013 Jun 18 - Jun 24, 2013 Jul 7 - Jul 13, 2013 Jul 15 - Jul 21, 2013 Jul 28 - Aug 3, 2013 Aug 5 - Aug 11, 2013 Sep 1 - Sep 7, 2013 (Adult Exclusive) Pennsylvania, District of Columbia and Virginia Please Select May 24 - May 31, 2013 Jun 18 - Jun 25, 2013 Jul 2 - Jul 9, 2013 Jul 19 - Jul 26, 2013 Aug 9 - Aug 16, 2013 Southern California Please Select Apr 28 - May 3, 2013 May 26 - May 31, 2013 Jun 9 - Jun 14, 2013 Jun 23 - Jun 28, 2013 Jun 30 - Jul 5, 2013 Jul 7 - Jul 12, 2013 Jul 21- Jul 26, 2013 Jul 28 -Aug 2, 2013 Aug 4 - Aug 9, 2013 Aug 11 - Aug 16, 2013 Sep 15 - Sep 20, 2013 Oct 13 - Oct 18, 2013 (Adult Exclusive) Oct 27 - Nov 1, 2013 Dec 15 - Dec 20, 2013 Jan 12, 2014 - Jan 17, 2014 Feb 16, 2014 - Feb 21, 2014 Wyoming Please Select Jun 17 - Jun 23, 2013 Jun 19 - Jun 25, 2013 Jun 26 - Jul 2, 2013 Jul 1 - Jul 7, 2013 Jul 8 - Jul 14, 2013 Jul 10 - Jul 16, 2013 Jul 15 - Jul 21, 2013 Jul 17 - Jul 23, 2013 Jul 24 - Jul 30, 2013 Jul 29 - Aug 4, 2013 Jul 31 - Aug 6, 2013 Aug 5 - Aug 11, 2013 Aug 7 - Aug 13, 2013 Aug 14 - Aug 20, 2013
Europe More information England & France Please Select May 10 - May 17, 2013 May 20 - May 27, 2013 May 31 - Jun 7, 2013 Jun 7 - Jun 14, 2013 Jun 14 - Jun 21, 2013 Jun 17 - Jun 24, 2013 Jun 21 - Jun 28, 2013 Jun 24 - Jul 1, 2013 Jun 28 - Jul 5, 2013 Jul 1 - Jul 8, 2013 Jul 12 - Jul 19, 2013 Jul 15 - Jul 22, 2013 Jul 19 - Jul 26, 2013 Jul 22 - Jul 29, 2013 Jul 26 - Aug 2, 2013 Aug 2 - Aug 9, 2013 Aug 12 - Aug 19, 2013 Aug 16 - Aug 23, 2013 Aug 19 - Aug 26, 2013 Aug 23 - Aug 30, 2013 Sep 9 - Sep 16, 2013 Sep 20 - Sep 27, 2013 (Adult Exclusive) Sep 30 - Oct 7, 2013 Dec 20 - Dec 27, 2013 Dec 27, 2013 - Jan 3, 2014 France Please Select May 23 - May 30, 2013 May 30 - Jun 6, 2013 Jun 13 - Jun 20, 2013 Jun 20 - Jun 27, 2013 Jun 27 - Jul 4, 2013 Jul 4 - Jul 11, 2013 Jul 11 - Jul 18, 2013 Jul 18 - Jul 25, 2013 Jul 25 - Aug 1, 2013 Aug 1 - Aug 8, 2013 Aug 8 - Aug 15, 2013 Germany Please Select May 24 - Jun 1, 2013 Jun 14 - Jun 22, 2013 Jun 21 - Jun 29, 2013 Jun 23 - Jul 1, 2013 Jun 30 - Jul 8, 2013 Jul 5 - Jul 13, 2013 Jul 12 - Jul 20, 2013 Jul 14 - Jul 22, 2013 Jul 21 - Jul 29, 2013 Jul 26 - Aug 3, 2013 Aug 2 - Aug 10, 2013 Aug 4 - Aug 12, 2013 Aug 16 - Aug 24, 2013 Sep 15 - Sep 23, 2013 (Adult Exclusive) Sep 20 - Sep 28, 2013 (Adult Exclusive) Greece Please Select May 24 - Jun 2, 2013 (Adult Exclusive) Jun 11 - Jun 20, 2013 Jun 21 - Jun 30, 2013 Jul 2 - Jul 11, 2013 Jul 5 - Jul 14, 2013 Jul 16 - Jul 25, 2013 Jul 19 - Jul 28, 2013 Aug 2 - Aug 11, 2013 Aug 6 - Aug 15, 2013 Aug 13 - Aug 22, 2013 Sep 27 - Oct 6, 2013 (Adult Exclusive) Ireland Please Select Jun 1 - Jun 8, 2013 Jun 11 - Jun 18, 2013 Jun 22 - Jun 29, 2013 Jul 2 - Jul 9, 2013 Jul 13 - Jul 20, 2013 Jul 23 - Jul 30, 2013 Aug 3 - Aug 10, 2013 Aug 13 - Aug 20, 2013 Sep 14 - Sep 21, 2013 (Adult Exclusive) Italy Please Select Apr 21 - Apr 29, 2013 May 16 - May 24, 2013 May 19 - May 27, 2013 (Adult Exclusive) May 23 - May 31, 2013 May 27 - Jun 4, 2013 Jun 2 - Jun 10, 2013 Jun 6 - Jun 14, 2013 Jun 9 - Jun 17, 2013 Jun 13 - Jun 21, 2013 Jun 17 - Jun 25, 2013 Jun 20 - Jun 28, 2013 Jun 23 - Jul 1, 2013 Jun 27 - Jul 5, 2013 Jun 30 - Jul 8, 2013 Jul 4 - Jul 12, 2013 Jul 8 - Jul 16, 2013 Jul 11 - Jul 19, 2013 Jul 14 - Jul 22, 2013 Jul 18 - Jul 26, 2013 Jul 21 - Jul 29, 2013 Jul 28 - Aug 5, 2013 Aug 1 - Aug 9, 2013 Aug 5 - Aug 13, 2013 Aug 8 - Aug 16, 2013 Aug 11 - Aug 19, 2013 Aug 15 - Aug 23, 2013 Aug 18 - Aug 26, 2013 Aug 25 - Sep 2, 2013 Sep 15 - Sep 23, 2013 (Adult Exclusive) Oct 6 - Oct 14, 2013 Oct 13 - Oct 21, 2013 Dec 21 - Dec 29, 2013 Italy Signature Please Select May 9 - May 17, 2013 (Adult Exclusive) Jun 13 - Jun 21, 2013 Jul 4 - Jul 12, 2013 Jul 18 - Jul 26, 2013 Aug 1 - Aug 9, 2013 Sep 5 - Sep 13, 2013 (Adult Exclusive) Central Italy Please Select May 26 - Jun 2, 2013 Jun 9 - Jun 16, 2013 Jun 16 - Jun 23, 2013 Jul 3 - Jul 10, 2013 Jul 7 - Jul 14, 2013 Jul 21 - Jul 28, 2013 Jul 31 - Aug 7, 2013 Aug 11 - Aug 18, 2013 Sep 29 - Oct 6, 2013 (Adult Exclusive) Italy and Switzerland Please Select Jun 9 - Jun 16, 2013 Jun 27 - Jul 4, 2013 Jun 30 - Jul 7, 2013 Jul 11 - Jul 18, 2013 Jul 21 - Jul 28, 2013 Jul 28 - Aug 4, 2013 Aug 8 - Aug 15, 2013 Sep 8 - Sep 15, 2013 (Adult Exclusive) Scotland Please Select June 9 - June 17, 2013 June 22 - June 30, 2013 June 30 - July 8, 2013 July 22 - July 30, 2013 August 4 - August 12, 2013 August 18 - August 26, 2013 September 15 - September 23, 2013 (Adult Exclusive)
AIR TRAVEL, TRIP INSURANCE Would you like to include air travel in your quote? Yes No If so, from what city Make a Selection Abilene, TX (ABI) Akron/Canton, OH (CAK) Albany, NY (ALB) Albuquerque, NM (ABQ) Allentown, PA (ABE) Amarillo, TX (AMA) Anchorage, AK (ANC) Asheville, NC (AVL) Athens, GA (AHN) Atlanta, GA (ATL) Atlantic City, NJ (ACY) Augusta, GA (AGS) Austin, TX (AUS) Baltimore (Washington, DC), MD (BWI) Bangor, ME (BGR) Baton Rouge, LA (BTR) Billings, MT (BIL) Binghamton, NY (BGM) Birmingham, AL (BHM) Bismarck, ND (BIS) Bloomington, IL (BMI) Blountville, TN (TRI) Boise, ID (BOI) Boston, MA (BOS) Bozeman, MT (BZN) Bradford, PA (BFD) Buffalo, NY (BUF) Burlington, VT (BTV) Cedar Rapids, IA (CID) Champaign, IL (CMI) Charleston, WV (CRW) Charleston, SC (CHS) Charlotte, NC (CLT) Charlottesville, VA (CHO) Chattanooga, TN (CHA) Chicago, IL (MDW) Chicago, IL (ORD) Cincinnati, OH (CVG) Clarksburg, WV (CKB) Cleveland, OH (CLE) Colorado Springs, CO (COS) Columbia, SC (CAE) Columbus, OH (CMH) Corpus Christi, TX (CRP) Dallas/Ft. Worth, TX (DFW) Dayton, OH (DAY) Denver, CO (DEN) Des Moines, IA (DSM) Detroit, MI (DTW) Dubois, PA (DUJ) El Paso, TX (ELP) Elmira, NY (ELM) Erie, PA (ERI) Eugene, OR (EUG) Evansville, IN (EVV) Fargo, ND (FAR) Fayetteville, AR (XNA) Fayetteville, NC (FAY) Flint, MI (FNT) Fort Wayne, IN (FWA) Franklin, PA (FKL) Fresno, CA (FAT) Grand Rapids, MI (GRR) Great Falls, MT (GTF) Green Bay, WI (GRB) Greensboro, NC (GSO) Greenville, SC (GSP) Hagerstown, MD (HGR) Harlingen, TX (HRL) Harrisburg, PA (MDT) Hartford, CT (BDL) Helena, MT (HLN) Hilton Head, SC (HHH) Honolulu, HI (HNL) Houston, TX (IAH) Huntington, WV (HTS) Huntsville, AL (HSV) Indianapolis, IN (IND) Islip-Long Island, NY (ISP) Ithaca, NY (ITH) Jackson, MS (JAN) Jamestown, NY (JHW) Johnstown, PA (JST) Kalamazoo, MI (AZO) Kansas City, MO (MCI) Knoxville, TN (TYS) LaTrobe, PA (LBE) Lancaster, PA (LNS) Lansing, MI (LAN) Las Vegas, NV (LAS) Lexington, KY (LEX) Lincoln, NE (LNK) Little Rock, AR (LIT) Los Angeles, CA (LAX) Louisville, KY (SDF) Lubbock, TX (LBB) Lynchburg, VA (LYH) Madison, WI (MSN) Manchester, NH (MHT) McAllen, TX (MFE) Memphis, TN (MEM) Meridian, MS (MEI) Midland, TX (MAF) Milwaukee, WI (MKE) Minneapolis/St. Paul, MN (MSP) Missoula, MT (MSO) Mobile, AL (MOB) Moline, IL (MLI) Monroe, LA (MLU) Montgomery, AL (MGM) Morgantown, WV (MGW) Myrtle Beach, SC (MYR) Nashville, TN (BNA) New Bern, NC (EWN) New Orleans, LA (MSY) New York, NY (LGA) New York, NY (JFK) Newark, NJ (EWR) Newburgh/Stewart, NY (SWF) Newport News, VA (PHF) Norfolk, VA (ORF) Oakland, CA (OAK) Oklahoma City, OK (OKC) Omaha, NE (OMA) Ontario, CA (ONT) Orange County, CA (SNA) Pasco, WA (PSC) Peoria, IL (PIA) Philadelphia, PA (PHL) Phoenix, AZ (PHX) Pittsburgh, PA (PIT) Portland, ME (PWM) Portland, OR (PDX) Providence, RI (PVD) Raleigh/Durham, NC (RDU) Rapid City, SD (RAP) Reading, PA (RDG) Reno, NV (RNO) Richmond, VA (RIC) Roanoke, VA (ROA) Rochester, MN (RST) Rochester, NY (ROC) Sacramento, CA (SMF) Saginaw, MI (MBS) Salisbury, MD (SBY) Salt Lake City, UT (SLC) San Antonio, TX (SAT) San Diego, CA (SAN) San Francisco, CA (SFO) San Jose, CA (SJC) San Juan, PR (SJU) Savannah, GA (SAV) Seattle, WA (SEA) Shreveport, LA (SHV) Sioux Falls, SD (FSD) South Bend, IN (SBN) Spokane, WA (GEG) Springfield, MO (SGF) Springfield, IL (SPI) St. Louis, MO (STL) State College, PA (SCE) Syracuse, NY (SYR) Texarkana, AR (TXK) Toledo, OH (TOL) Tucson, AZ (TUS) Tulsa, OK (TUL) Washington, DC (DCA) Washington, DC (IAD) Wausau, WI (CWA) Wichita, KS (ICT) Wilkes-Barre, PA (AVP) Williamsport, PA (IPT) Wilmington, NC (ILM) Worcester, MA (ORH) Preferred airline carrier Would you be willing to make a stop or connection Yes No What class of air travel would you prefer? Economy Business First Class Would you like Trip Cancellation and Interruption Insurance Yes No Selecting NO for Trip Cancellation and Interruption insurance means you decline to purchase Insurance for your vacation.
PLEASE TELL US How did you find out about our website Please Select I am a past client Referred by a past client Advertising on Minivan AOL Search Car Wrap Disney Driven Life Disneytrivia.net Facebook Forodisney.com Google Inside the Magic Podcast Insidethemagic.net Micechat.com MickeyNews.com Message Board Patch Podcast Radio Disney Retail Location SR950 TalkDisney.com Twitter WaltDisneyBoards.com WDWNewsToday.com WDW News Today Podcast Yahoo Other If you are already working with one of our agents please list their name Regarding this quote request Please Select Getting an idea on what an Adventures by Disney Vacation costs Definitely plan on booking but would need more information on the specific Adventure Have traveled with other escorted tours and wanted to compare prices Would you like to be added to our mailing list to receive information on special offers? Yes No
Travel Dates If your travel dates are flexible please list your information below. Special Occasions Please list below any special occasions you will be celebrating while on your vacation. Groups Please list your parties breakdown per room. Include how many adults and how many children along with the children's ages that will be in each room.
New and Past Clients If there is a particular agent you would like to help plan your vacation please let us know. If your family or friends have referred you to Magical Travel please list their name so we can thank them. Questions, Comments, Additional Information The latest Adventures by Disney offer will be included with your price quote.
ATTENTION: YOU WILL NOT RECEIVE A QUOTE IF THE AGES OF THE CHILDREN ARE MISSING. PRICING IS BASED ON THE THE AGES OF THE CHILDREN.
