Please enter your name on the registration form as it appears on your government-issued photo ID. Flight tickets will be issued in accordance with your registered name.

First Name as it appears on your ID *

Middle name as it appears on your ID *

Last name as it appears on your ID *

Known Traveler Number (Global Entry, TSA Pre-check)

United Airlines Frequent Flyer Number:

Name preference for your name tag: *

Date of birth (MM/DD/YYYY) * +

Email Address *

Email Confirmation *

Color copy of your ID (attach now or send to Executive Travel minimum 90 days prior to departure)

Street Address *

Address Line 2

City *

State *

Zip Code *

Home Phone Number

Cell Phone Number *

Are you a solo traveler or traveling with a companion? *

Traveling Solo

With a Companion

Looking for a Roommate "Pair & Share"

First name as it appears on your ID

Middle name as it appears on your ID

Last name as it appears on your ID

Known Traveler Number (Global Entry, TSA Pre-check)

Frequent Flyer Number:

Name preference for your name tag:

Date of birth (MM/DD/YYYY) +

Email Address

Email Confirmation

Color copy of your ID (attach now or send to Executive Travel minimum 90 days prior to departure)

Street Address

Address Line 2

City

State

Zip Code

Home Phone Number

Cell Phone Number

Are you interested in a quote for Travel Insurance? *

Yes

No

If any food allergies exist, please list them here:

0/300 characters

Bed preference (will be requested, but cannot be guaranteed):

0/300 characters

If you are traveling with friends, please list their names here:

Please indicate if you want to sign up for an optional excursion. Pricing is estimated at this time, but registration is binding. You may sign up until the time that final payment is due (120 days prior to departure). *

Optional Tour #1: Oahu Circle Island Tour (estimate $175)

Optional Tour #2: Kona Whale Watching Cruise (estimate $160)

Will you need air transportation from a different airport than Omaha? *

Yes

No

Please indicate which airport you will need air transportation from: *

How would you like to make your deposit payment? (please note: if you choose to pay by credit card and you register two people, both deposits will be charged to this card) *

Check

Credit Card

Name on Card *

Credit Card Type *

Credit Card Number *

CVC Code *

Expiration Date (mm/yy) *

PIN Number (if applicable)

By submitting this form, you authorize Executive Travel to charge this credit card for the deposit amount for the traveler(s) above. Forwarding registration and deposit signifies that you agree to the terms and conditions of this tour which can be found on our website at executivetravel.com/eti-home/vacation/escorted-tours *

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