Lozeron Travel

Booking Form

Please fill in the form below. All information must match exactly what appears on your passport any incorrect information could result in a charge for correction.

Guest # 1 Name *

Prefix	First Name	Middle Name	Last Name

Birth Date *


Month	Day	Year

Citizenship *

Gender *

Do you have another guest to add?

Yes
No

Guest # 2 Name *

Prefix	First Name	Middle Name	Last Name

Birth Date *


Month	Day	Year

Citizenship *

Gender *

Do you have another guest to add?

Yes
No

Guest # 3 Name *

Prefix	First Name	Middle Name	Last Name

Birth Date *


Month	Day	Year

Citizenship *

Gender *

Do you have another guest to add?

Yes
No

Guest # 4 Name *

Prefix	First Name	Middle Name	Last Name

Birth Date *


Month	Day	Year

Citizenship *

Gender *

Do you have another guest to add?

Yes
No

Guest # 5 Name *

Prefix	First Name	Middle Name	Last Name

Birth Date *


Month	Day	Year

Citizenship *

Gender *

Do you have another guest to add?

Yes
No

Guest # 6 Name *

Prefix	First Name	Middle Name	Last Name

Birth Date *


Month	Day	Year

Citizenship *

Gender *

Will you be rooming with another guest?	Yes No, Single Rate
Name of Guest

Phone Number *

-
Area Code	Phone Number

Cell Phone Number

-
Area Code	Phone Number

Address *


Street Address

Street Address Line 2

City	State

Postal / Zip Code	Country

E-mail *

Room Category *	Junior Suite
Duration *	Nights
Gateway *	Calgary Edmonton via Calgary Vancouver Grande Prairie via Calgary Winnipeg via Toronto Toronto

Special Requests

Payment Information

Type of Credit Card

Credit Card Number

Name as it appears on Credit Card

Expiry Month

Expiry Year

CVV

Billing Address

Same as above


Street Address

Street Address Line 2

City	State

Postal / Zip Code	Country

Total Payment ($150.00 per person NON REFUNDABLE deposit)*

I agree to the above terms and conditions *
Terms and Conditions It is the responsibility of the passenger to verify documentation requirements direct with the embassy or consulate of the country of travel. Customs and/or immigation officials can deny a person entry into their country at their own discretion. We strongly recommend traveling with a passport that is valid for at least 6 months beyond your return date. Log on to www.voyage.gc.ca for country information. Please be aware that different living standards and practices exist outside of Canada including by not limited to provisions of utilities, accommodations and services of all kinds. Deposits are nonrefundable and non-transferrable. Change fees may apply. It is extremely important that all clients purchase out of country medical insurance. We strongly recommend that all clients purchase cancellation and interruption travel insurance. Lozeron Travel and Trevello Travel Group cannot be held responsible for any errors, ommissions or mistakes on this form. Your reservation is subject to the rules and conditions of the tour operator.

Booking Form

Payment Information

Terms and Conditions