Advisor Registration

top of page

PLEASE FILL OUT FORM COMPLETELY TO BOOK!

BY SUBMITTING THIS FORM YOU ARE APPROVING LUX LAND & SEA TO BOOK YOUR CRUISE.
I will reach out with your Celebrity confirmation once booking is complete. If you would rather give CC confirmation over the phone, please indicate and I can call you directly to complete booking. Make sure to hit the SUBMIT button when finished.
THANK YOU!

GUEST 1:

* Legal First Name

Middle Name (option)

*Last Name

*Birth Date (mm/dd/year)

*Email

*Phone

*Address 1

Address 2 (optional)

*City

*State

*Country

*Zip Code

*Emergency Contact Name

*Emergency Contact Phone Number

*Emergency Contact Relationship

GUEST 2:

*Legal First Name

Middle Name (optional)

*Last Name

*Birth Date (mm/dd/year)

*Email

*Phone

*Address 1

Address 2 (optional)

*City

*State

*Country

*Zip Code

*Emergency Contact Name

*Emergency Contact Phone Number

*Emergency Contact Relationship

Stateroom Selection:

*Staterooms:

Prime Inside ($2389)

Veranda ($2985)

Concierge Veranda ($3159)

*Bed Configuration

Together

Apart

*Dining time

Anytime

8:00pm

Include pre-paid gratuities with total price. If not prepaid, total gratuities of $136.50 pp (inside and veranda) and $143.50 pp (concierge class) will be automatically charged to each guest onboard account upon conclusion of cruise.

I'd prefer to give CC information over the phone. (Please skip to payments sections below)

Credit Card Payment Information:

Number

Exp. Date

Code

Billing Address (if different from above):

Address 1

Address 2 (optional)

City

State

Country

Zip Code

*Payments

PAY IN FULL

JUST PAY DEPOSIT ($500)

Interested one-night PRE-CRUISE hotel stay

Interested in 3-Day POST-CRUISE extension

bottom of page