DUBAI BOOKING FORM
FOR RESERVATIONS TELEPHONE 0844 493 1255
Please complete fully and return with remittance to:
Gold Medal Holidays, The Trident Centre, Port Way, Ribble Docklands, Preston PR2 2QG.
Alternatively fax to 01772 835251.
NAME & ADDRESS FOR CORRESPONDENCE
ALL OTHER PASSENGER NAMES & DETAILS
AS SHOWN IN PASSPORT
Mr/Mrs/Ms: First Name: Surname:
MR/MRS
DATE
INSURANCE
MS/MISS FIRST NAME SURNAME Delete as
OF BIRTH
Address:
If under 18 YRS
MSTR. required
or over 65 YRS

YES/NO

YES/NO
YES/NO
TION

YES/NO
Postcode:
YES/NO
Home Tel No*: Daytime Tel No*:
YES/NO
*IMPORTANT: IN THE EVENT OF STRIKE OR SERIOUS DELAY
YES/NO
INFORMA
114
ACCOMMODATION 115
NO. OF ROOMS
CHECK-IN NO. OF
TOUR CODE CITY/TOWN/RESORT HOTEL ACCOMMODATION MEAL PLAN ROOM TYPE
Single Twin Triple
DATE NIGHTS
FLIGHT INFORMATION SPECIAL REQUESTS/OTHER REQUIREMENTS
FLIGHT NO. DATE FROM TO DEPARTURE ARRIVAL
FLIGHT BOOKING REF. (IF APPLICABLE)
DEPOSIT & HOLIDAY INSURANCE PAYMENT DECLARATION
A deposit is payable at the time of booking or the full amount if within 8 weeks of departure. Please reserve the holidays shown for the person/s listed above. I enclose a deposit, as advised at the
time of booking, or full payment (where travel is within 8 weeks). I also enclose the relevant insurance
premium for each person travelling unless I have deleted the word ‘Yes’ from the insurance panel
DEPOSIT PASSENGERS AT =
on the booking form. I also enclose the relevant insurance premium for each person travelling unless
I have deleted the word ‘Yes’ from the insurance panel on the booking form.
I have read, understood and accept the Conditions of Booking and Insurance as shown on
INSURANCE PASSENGERS AT =
pages 113 and 114 on behalf of all persons listed. I also accept that all persons listed are
themselves responsible for seeing that immigration and health requirements are fulfilled.
I am over 18 years of age.
FULL PAYMENT PASSENGERS AT =
Signature: Date:
TOTAL AMOUNT INCLUDED =
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