Client Preference Intake Form

Primary Contact First & Last Name

Primary Contact Email Address

Primary Email Address

Street Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Wedding Anniversary - if Applicable

YYYY

Emergency Contact Name & Phone Number (someone who does not travel with you)

Traveler #1 Personal Information

(First, Middle, and Last Name it appears on passport)

First Name

Last Name

Preferred Name

Phone

(###)

###

####

Gender

Date of Birth

YYYY

Allergies or Dietary Restrictions- Please Describe Restrictions

Mobility or Medical Needs- Please Describe Needs

Frequent Flyer Number

Preferences & Interests of Traveler #1

Airline Seating Preference

Airline Loyalty Number(s)

Hotel Loyalty Number(s)

Rental Car Loyalty Number(s)

Type of Rental Car Preferred

Hobbies or Interests

Please tell us about any special preferences or needs (including preferred bedding)

Do you have another traveler to add?

This form allows up to 6 travelers. Once you have added all of your travelers, please proceed to "Signature." If you have more than 6 travelers apart of your group, we'll collect the additional travelers' information through later client service communication.

Traveler #2 Personal Information

(First, Middle, and Last Name it appears on passport)

First Name

Last Name

Preferred Name

Phone

(###)

###

####

Gender

Date of Birth

YYYY

Allergies or Dietary Restrictions- Please Describe Restrictions

Mobility or Medical Needs- Please Describe Needs

Frequent Flyer Number

Preferences & Interests of Traveler #2

Airline Seating Preference

Airline Loyalty Number(s)

Hotel Loyalty Number(s)

Rental Car Loyalty Number(s)

Type of Rental Car Preferred

Hobbies or Interests

Please tell us about any special preferences or needs (including preferred bedding)

Do you have another traveler to add?

Traveler #3 Personal Information

(First, Middle, and Last Name as it appears on passport)

First Name

Last Name

Preferred Name

Phone

(###)

###

####

Gender

Date of Birth

YYYY

Allergies or Dietary Restrictions - Please Describe

Mobility or Medical Needs- Please Describe

Frequent Flyer Number

Preferences & Interests of Traveler #3

Airline Seating Preference

Airline Loyalty Number(s)

Hotel Loyalty Number(s)

Rental Car Loyalty Number(s)

Type of Rental Car Preferred

Hobbies or Interests

Please tell us about any special preferences or needs (including preferred bedding)

Do you have another traveler to add?

Traveler #4 Personal Information

(First, Middle, and Last Name as it appears on passport)

First Name

Last Name

Preferred Name

Phone

(###)

###

####

Gender

Date of Birth

YYYY

Allergies or Dietary Restrictions- Please Describe

Mobility or Medical Needs- Please Describe

Frequent Flyer Number

Preferences and Interests of Traveler #4

Airline Seating Preference

Airline Loyalty Number(s)

Hotel Loyalty Number(s)

Rental Car Loyalty Number(s)

Type of Rental Car Preferred

Hobbies or Interests

Please tell us about any special preferences or needs (including preferred bedding)

Do you have another traveler to add?

Traveler #5 Personal Information

First, Middle, and Last Name as it appears on passport)

First Name

Last Name

Preferred Name

Phone

(###)

###

####

Gender

Date of Birth

YYYY

Allergies or Dietary Restrictions- Please Describe Restrictions

Mobility or Medical Needs- Please Describe Needs

Frequent Flyer Number

Preferences & Interests of Traveler #5

Airline Seating Preference

Airline Loyalty Number(s)

Hotel Loyalty Number(s)

Rental Car Loyalty Number(s)

Type of Rental Car Preferred

Hobbies or Interests

Please tell us about any special preferences or needs (including preferred bedding)

Do you have another traveler to add?

Traveler #6 Personal Information

(First, Middle, and Last Name as it appears on passport)

First Name

Last Name

Preferred Name

Phone

(###)

###

####

Gender

Allergies or Dietary Restrictions- Please Describe Restrictions

Mobility or Medical Needs- Please Describe Needs

Frequent Flyer Number

Preferences & Interests of Traveler #6

Airline Seating Preference

Airline Loyalty Number(s)

Hotel Loyalty Number(s)

Rental Car Loyalty Number(s)

Type of Rental Car Preferred

Hobbies or Interests

Please tell us about any special preferences or needs (including preferred bedding)

Signature

Please ensure that all of the information above is accurate and true before continuing.

Resort to Laura Madrid is pleased to provide a Travel and Cancellation insurance quote for your travels, but I understand that it is ultimately my responsibility to request travel insurance and to ensure it is confirmed on my behalf.

By typing your name here, you are signing this form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.

By signing below, you agree to the following Terms and Conditions: http://www.resorttolauramadrid.com/terms-conditions-1