ceriana reg

Registration for “Live Like an Italian”

Please submit a separate registration for each traveler

After you complete and submit this form, you will automatically be re-directed to the Payment Page for secure online payment by credit or debit card. A $500 deposit ($525 via credit card) is required to reserve your space on this tour.

Ceriana Italy

First Name

The name you enter above must be exactly as it appears or will appear on your passport.

Middle (if applicable)

Last Name

The name you enter above must be exactly as it appears or will appear on your passport.

Birth Date (Day/Month spelled out/Year) *

Address *

Number & Street

City *

State/Province *

ZIP/Postal Code *

Country

If not USA

Phone *

I am *

Male

Female

Passport Number

If you do not have a passport at this time, please submit this form now and provide RMC with your passport information after you receive your passport.

Country of Issue *

Passport Issue Date (Day/Month spelled out/Year)

Passport Expiry Date (Day/Month spelled out/Year)

Your passport expiry date should be more than six months after the ending date of this tour.

I am requesting rental for: *

Apartment

Studio Suite

Rental Period: *

3 Nights

5 Nights

7 Nights

Rental Season: *

May-October

November-June

Rental Days/Dates Requsted: *

Optional Message

If you require a special diet or have physical limitations that require special attention, please describe here. (Most situations can be accommodated, but we must know beforehand in order to make arrangements, and there may be additional costs.) [CERIANA]

If you are human, leave this field blank.

By submitting this form, you are accepting the Terms & Conditions.

RMC highly recommends the purchase of Trip Cancellation Insurance, and our preferred Insurance provider is Allianz.