Sundial Special Vacations Traveler Profile

SSV requires that each new & existing traveler complete a profile annually. This form is required before travel arrangements are made. If you have already filled out this form in the current year, you can proceed to BOOK YOUR TOUR without filling out this form again.

1

Traveler Profile

2

Medical Information & Advisories

3

Waivers & Release

Name exactly as it appears on government issued ID

Preferred Name

Date of Birth *

Month

Day

Year

Sex

Male

Female

Traveler Email

If traveler has no email please list care giver's email.

Mailing Address (Where you would like your package to be mailed to.)

Mailing Address (Where you would like your package to be mailed to.)

Country/Region

Address

Address - line 2

City

Zip / Postal code

Phone

24 HR Emergency Contact Person

This person listed MUST be able to immediately assist with important information

24 HR Emergency Contact Person Phone #

Care Provider/Agency Name

Care Provider/Agency Mailing Address

Mailing Address (Where you would like your package to be mailed to.)

Country/Region

Address

Address - line 2

City

Zip / Postal code

Care Provider Email

Physicians Name

Physician Phone #

Can Vacationer Travel Alone by Air?

Yes

Please explain specific needs if vacationer is unable to travel alone by air.

Is traveler confined to a wheel chair?

Yes

If yes, please call our office.

Please tell us all about yourself (eg. I smoke, I like to swim, I tire easily)

Please include anything that our Tour Guides should know.

Please upload a copy of a valid State or Federally Issued ID such as ID Card, Passport, Drivers License

If traveling on cruise or international vacations, a passport is mandatory.

Please upload a CLEAR & CURRENT photo