2011 SentryNet Dealer Cruise : Dealer Registration Form

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Dealer Registration Early Buy-in Form

Early Buy in is $50 per person. All cabins require double occupancy. The Buy-in fee will be refunded if enough points are earned to cover your ticket.

1) Dealer Company Specifics

Company Name: *
Contact Name: *
E-Mail Address: *
Dealer No.: *
Phone: *

2) Double Occupancy Purchase Required:
All cabins require double occupancy and the Early Buy-in is only offered per Cabin. This means your account will be charge $100 per cabin you Buy-in for at this time. When completing the registration form please complete the Full Legal name of the main person staying in the cabin as required by customs. If you do not want, have or know the name of your cabin mate at present you can put N/A in that space as the information for the second person can be added at a later date. After registration you will be given your booking number so that you can begin to complete your Fun Pass and plan your Cruise. If at the end of the contest you have enough points to cover your Cruise tickets we will completely refund your early buy-in fee. Early Buy-in begins June 1st and will end on December 1, 2010. Cancellations made after December 29th will forfeit their early buy-in fee. We must collect your full legal names, US Citizen status, and special medical conditions( Note: If pregnant and 26 weeks or later at Sailing date you can not be permitted on board ) etc. If you have any questions please review our Cruise FAQ.

First Person
Full Legal Name
Roomate Relation
US Citizen Status
Age
Gender
Special Medical Needs
If Other, Specify:

Second Person
Full Legal Name
Roomate Relation
US Citizen Status
Age
Gender
Special Medical Needs
If Other, Specify:

3) Authorize Buy-in Charge on Dealer Account

Amount to Charge $
Authorized Signature
Authorized Email

I authorize SentryNet to bill my dealer account $100 USD
	Yes, bill my dealer account No, ( Call SentryNet 800-932-3304 )

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