Please fill out the following information and we will contact you shortly to verify receipt of your information and answer any further questions you may have. Upon confirming your participation in the tour, a non-refundable deposit of $1,500 for the Explorer Tour and $2,500 for the Connoisseur Tour is required. Payment can be made by major credit card, check or wire transfer. We look forward to experiencing Bali with you.
* Fares shown do not include tax and fuel sucharge of $293 which is subject to change prior to time of booking. Should the airline impose higher fuel surcharges, you will be notified prior to ticketing. Economy class fares pricing is guaranteed but must be ticketed prior to December 31. Fares listed for first, business and executive classes are subject to change and will be reconfirmed prior to actual ticketing.
Any City - Gateway City
City:
State:
Economy Class. Please provide me connecting flight information and pricing.
Business Class. Please provide me connecting flight information and pricing.
No flight required
Personal Information
1.
Salutation:
First Name:
Last Name:
Birthdate:
Passport Number:
Address:
City:
State:
Zip:
E-mail:
Day Phone:
Evening Phone:
Fax:
2.
Salutation:
First Name:
Last Name:
Birthdate:
Passport Number:
Address:
City:
State:
Zip:
E-mail:
Day Phone:
Evening Phone:
Fax:
Accommodations
Double/One Bed
Double/Twin Beds
Single*
Smoking Room
Non-Smoking Room
No Preference
Special Requests For Room:
Please contact me to discuss Villa and other accommodation upgrades.
* We will contact you to discuss fees for single supplement.
Special Requests
Special Diet:
Yes
No
If Yes, Please Explain:
If you are a vegetarian and/or have food restrictions/allergies please bring it/them to our attention.
Do you have any problems climbing or walking stairs?
Yes
No
Please Let Us Know If You Have Any Other Special Needs Or Requirements: