Trip Booking Registration

Thank you in advance for booking with Gold N Dayz Travel!

Please complete the form below carefully. Any questions feel free to contact us directly.

Trip Booking Registration ~ Darell's 50th "In My Homeland" ~ Panama

Full Name (as listed on Passport) *

Full Name (as listed on Passport)

First

Last

Date of Birth *

Social Media Names *

Social Media Names

Facebook

Instagram

Phone Number *

Email Address *

Check here to receive email updates

I agree to receive email updates from Gold N Dayz Travel

Roommate Full Name (If Applicable)

Roommate Full Name (If Applicable)

First

Last

Date of Birth

Roommate Social Media Names

Facebook

Instagram

Roommate Phone Number (If Applicable)

Roommate Email Address

Check here to receive email updates

I agree to receive email updates from Gold N Dayz Travel

Select Room Type: *

Double Occupancy

Select Bed Type: *

Double Beds

King Bed

Select Room Category: *

Preferred Club Ocean View

Preferred Junior Ocean View Suite

Covid-19: Are you vaccinated? *

Yes

Provide Deposit amount sent: *

How will your deposit be sent? *

Debit/Credit Card (complete below)

Zelle

CashApp

Venmo

Click Here for Payment Options.

Complete the following fields if paying by Debit/Credit Card. If not, skip to the "Who Referred you?" section

I authorize Gold N Dayz Travel to charge my card for the amount indicated.

Payment Amount

Date of Birth

Who referred you? *

Notes

Acknowledgements: *

I have reviewed the CleanComplete Verification™ practices found below.

I have reviewed the CDC Travel Recommendations for the location of the trip I have selected – found below.

I have reviewed GoldnDayz Travel's travel insurance option found below.

I acknowledge that upon clicking "Submit" below, I will be redirected to PayPal to make my deposit. If I chose a different preferred payment method in the form above (Zelle, CashApp or Venmo) I will disregard the redirection and proceed to send GoldNDayz Travel my deposit on my platform of choice. See payment options and instructions below.

If you are human, leave this field blank.

CLEANCOMPLETE VERIFICATION

CDC TRAVEL RECOMMENDATIONS

TRAVEL INSURANCE OPTION

Trip Booking Registration

EVENTS

TRAVEL

PARTNERS

COMPANY