Confirmed Passenger Information Form

NOTE: This form is only for those who have booked a multiple-day trips with us.

Please fill out this form and print it out and mail it to the address provided.
(Tip: COPY and PASTE the form into a word processing program. Fill
in the blanks and then print out two copies: one for you and one for us.)

Galley Gourmet
PO Box 1694
Kodiak, AK 99615

Please provide us with the following information as soon as possible upon booking a multiple-day cruise with us. We find it important to have some basic information about each guest to assist in planning and preparing for your visit. Feel free to add any additional information, requests, etc.

* This information is required.

Special occasion? Please describe: ___________________________

Your name* __________________________

Mailing address* ________________________________

City* __________________________ State/province* _______________

Zip code/postal code* _______________

Country* __________________________

Phone* __________________________

Email* __________________________

Birth date __________________________

Dates of your cruise aboard the Sea Breeze

Begin date* _____________________ Ending date* _____________________

When are you arriving in Kodiak? (We suggest you arrive at least one day ahead of your departure on the Sea Breeze and allow for an extra day after returning.)

Date* __________________________ Time* __________________________

Where will you be staying the night before your trip with us? (In case we need to get in touch with you)

Hotel or B&B* __________________________

Phone* __________________________

Emergency contact person and phone number

Name* __________________________

Phone* __________________________

Personal physician you would like us to contact in the event of an emergency:

Physician __________________________ located in (state/prov) __________________

Phone __________________________

List any medical conditions and medications you are currently taking:

____________________________________________________

List any allergies (bee stings, etc.) or special dietary needs (no milk, peanuts, vegetarian, etc.)

____________________________________________________

List any pertinent physical limitations:

____________________________________________________

Anything else you want us to know?

____________________________________________________

Thank you! We look forward to seeing you in Kodiak!