Para Español, Seleccione Lengua aquí o Presione aqui

Cruise Assistance Package (Cruise Without Our Staff)

No additional cost over the Cruise Line pricing.  The pricing you find on the cruise line websites, are the prices you pay.

ONLINE QUOTE/BOOKING FORM

WHAT's INCLUDED

CONTACTING US

  • You may call us and speak with a representative at any time for booking, quotes or information at 1-800-516-5247.

  • You may also email us at This email address is being protected from spambots. You need JavaScript enabled to view it.

Additional Services are available, which can be obtained seperately and added to your cruise reservation, after your cabin is reserved.

  • Airfare

  • Gratuities

  • Ground Transportation

  • Hotels

  • Insurance

  • 1-on-1 Respite Services

 

Page 1 of 3

Booking Form (Cruise WITHOUT Staff)

Complete as much information as you can to help us with arranging your cruise

* Required

Cruise Choice

Invalid Input

Cruise Line
Invalid Input

Departure Port City or State
Invalid Input

# of Cruise Nights
Invalid Input

choose as many as you like for quote purposes

Ship:
Invalid Input

Date of Sailing
Invalid Input

If you do not have a specific date, please choose the months that you would like a quote on:

Invalid Input

Cabin Preference

Invalid Input

Choose one or as many as you would like for a price comparison

Specify Other Cabin Type not Listed Above or a more detailed description/request:
Invalid Input

Total number of Passengers*
Invalid Input

Total Number of Cabins Desired*
Invalid Input

Requested Location for Multiple Cabins*
Invalid Input

Main Contact Person for Reservation

Salutation*
Invalid Input

FIRST & LAST Name*
Please let us know your name.

Street Address*
Invalid Input

Add'l Address Info
Invalid Input

City*
Invalid Input

Your State of Residence (or Country):
Invalid Input

Zip Code:*
Invalid Input

Country*
Invalid Input

Home Phone*
Invalid Input

Mobile Phone
Invalid Input

Work Phone
Invalid Input

Your Email*
Please let us know your email address.

***NOTE: Must complete PASSENGER INFORMATION section for Main Contact person if they are cruising***

1st PASSENGER INFORMATION

  • Each Passenger's First & Last name MUST be exactly as it appears on their identification.
  • Cruise lines require birth dates for all passengers
  • At least 1 person in each cabin must be 21 years old
  • Guests must be at least 6 months old
  • Restrictions apply for pregnant women
  • Contact Us for more info

Salutation
Invalid Input

First Name*
Invalid Input

Last Name*
Invalid Input

Date of Birth*
/ / Invalid Input

Citizenship:*
Invalid Input

Other Citizenship*
Invalid Input

Gender:*
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size*
Invalid Input

Disability*
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

List any medical conditions, needs or requests (Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

2nd PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

3rd PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

4th PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

5th PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

6th PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

Add additional Passengers?*
Invalid Input

 

7th PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

8th PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

9th PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

10th PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

11th PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

12th PASSENGER INFORMATION

Salutation
Invalid Input

First Name
Invalid Input

Last Name
Invalid Input

Date of Birth
/ / Invalid Input

Citizenship:
Invalid Input

Other Citizenship
Invalid Input

Gender:
Invalid Input

Past Passenger Cruise Line #:
Invalid Input

Shirt Size
Invalid Input

Disability
Invalid Input

Other Disability
Invalid Input

Bringing a Wheelchair
Invalid Input

Bringing Service Animal
Invalid Input

Special Needs Request

Please list any medical conditions, needs or requests here (such as Shower Stool, Mobility, Visual, Hearing, Oxygen, Dialysis, etc)

Invalid Input

A more detailed questionnaire will be sent closer to cruise date to collect special needs and dietary information.

 

Referrals

Referred By
Invalid Input

Full Name of Referrer
Invalid Input

Group Code provided by AotS (if any)
Invalid Input

Dining

Dining Time Preference

Invalid Input

If there is another party or person, not in this cabin, that you would like to sit with, please enter their full name here :  
Invalid Input

How did you learn about Autism on the Seas?
Invalid Input

Please specify what Organization or Other source
Invalid Input

Questions, Requests, Notes, or anything additional about your reservation
Invalid Input

Payment (Quote)

Deposit (or Full Payment if past Final Payment Date) is Due to Reserve Cabin

Or you may Request a Quote Only (see below)

I would like to pay by:

Invalid Input

Voucher, Discount Code or Gift Certificate Number/Code
Invalid Input

You will be credited appropriately on your Invoice.

Payment and Cancellation Fees

Please see the cruise line website for Information

CONFIRMATION / RECEIPT

You will receive an email confirming your booking request shortly after submission.

We will contact you to confirm cabin choices and/or pricing (if requested or needed).

You will receive an Invoice via email after your payment clears, which will include cruise information and any balances due.

Check payments will delay confirmations, which will delay receipt of your Paid Invoice.

{Security:caption}*
{Security:body}{Security:validation}

{Security:description}