Rock 'n' Roll Cruise Booking Form Ex Brisbane October 24 - 31, 2009

	Passenger 1:	Passenger 2:	Passenger 3:	Passenger 4:
Surname On Drivers License:
Given Names:
Date Of Birth:
Country Of Birth:
Passenger Nationality:

	Full Address Of Each Passenger Including State, Postcode, Country, Phone Numbers and Email Address:
PASSENGER 1 Home Address including State, P/Code and Country
PASSENGER 1 Home Phone and Mobile
PASSENGER 1 Email Adress:
PASSENGER 2 Home Address including State, P/Code and Country
PASSENGER 2 Home Phone and Mobile
PASSENGER 2 Email Address:
PASSENGER 3 Home Address including State, P/Code and Country
PASSENGER 3 Home Phone and Mobile
PASSENGER 3 Email Address:
PASSENGER 4 Home Address including State, P/Code and Country
PASSENGER 4 Home Phone and Mobile
PASSENGER 4 Email Address:

Do You Require Travel Insurance (Highly Recommended)?

Tick To Agree

* Please tick this box to confirm that all the passengers above agree to the cruise booking and passenger conditions located on P&O's web site located at www.pocruises.com.au or in their 2008 - 2010 holiday brochure.

* Indicates Response Required

	Passenger 1	Passenger 2	Passenger 3	Passenger 4
YES TO TRAVEL INSURANCE
NO TO TRAVEL INSURANCE