Sundial Special Vacations Traveler Profile

SSV requires that each new & existing traveler complete a profile annually. This form is required before travel arrangements are made. If you have already filled out this form in the current year, you can proceed to BOOK YOUR TOUR without filling out this form again.

1

Traveler Profile

2

Medical Information & Advisories

3

Waivers & Release

Name exactly as it appears on government issued ID

Preferred Name

Date of Birth *

Sex

Male

Female

Traveler Email

Mailing Address (Where you would like your package to be mailed to.)

Country/Region

Address

Address - line 2

City

Zip / Postal code

Phone

24 HR Emergency Contact Person

24 HR Emergency Contact Person Phone #

Care Provider/Agency Name

Care Provider/Agency Mailing Address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Care Provider Email

Physicians Name

Physician Phone #

Can Vacationer Travel Alone by Air?

Yes

Please explain specific needs if vacationer is unable to travel alone by air.

Is traveler confined to a wheel chair?

Yes

Please tell us all about yourself (eg. I smoke, I like to swim, I tire easily)

Please upload a copy of a valid State or Federally Issued ID such as ID Card, Passport, Drivers License

Please upload a CLEAR & CURRENT photo