Miles of Smiles
Progressive Travel Specialty Tours

Passenger Information Form

Note: Documents must be in or .PDF format, photos must be in .JPG format, and files can not exceed 24MB in total file size.
All fields with an asterisk (*) are required.

Traveler's Information

If you are a first time traveler with Progressive Travel please include a photo.

Traveler Photo

Note: Photo must be in .JPG format and it, along with an optional Medication Document found further below, can not exceed 24MB in total file size.


Multiple Day Trips

Name of roommate if any that you are traveling with:


Tour Payment Information



Yes   No

Show/Hide Additional Medication Fields

Note: Document must be in or .PDF format and it, along with the optional Traveler Photo found further above, can not exceed 24MB in total file size.

*Please complete the following information:

It is mandatory that this information is as accurate and up to date as possible for the traveler for which this reservation is for.

**Any questions marked “yes” that need an explanation, please do so in the text area below it!

 

I, have filled this form out to the best of my knowledge.

My relationship to this traveler is (Case Manager, Guardian, etc.).


Tour Contract

Emergency Medical Care Authorization

By signing this contract, I give permission for my assigned chaperone to proceed with emergency medical care and to sign necessary medical release forms. This permission is given with the understanding that the attending physician deems emergency medical attention is necessary. Progressive Travel, Inc. or a Chaperone will make every effort to reach the guardian prior to assuming the responsibility for signing a release for emergency medical treatment. This authorization will be used only in the event that the guardian cannot be reached.

Note: If not applicable please type N/A.

By signing, I acknowledge that I understand and agree to the terms of the Progressive Travel, Inc. Special Tour Contract.

(If you are the traveler's guardian, please fill out section below)


Photo Authorization Release