Samurai Tours Registration Form

Thank you for choosing Samurai Tours. We know you will thoroughly enjoy your Japanese adventure.

Please fill out the form below completely. Required fields are indicated with a right double arrow (») and a green label. For Travelers' information, enter names exactly as they appear on your passports, and be sure to select Gender and indicate Birthdate for ALL travelers. You can enter each traveler's passport information here if it is available or send it to us later.

Samurai Tours Mailing List

Each traveler also has the option to join our mailing list and receive monthly newsletters from Samurai Tours. To subscribe, click the Join Mailing List button, and enter the traveler's email address. Each traveler can unsubscribe at any time by following the unsubscribe instructions at the bottom of each newseltter announcement email.

Don't hesitate to contact us if you have any questions on how to use this form.

Tour Selection Tour Name and Date

Primary Contact Information

Address Line 1
Address Line 2
Address Line 3

City

Postal Code

Daytime Phone

State

Country

Evening Phone

Email Address

Traveler Information

You can register up to six travelers on this page. Please use the tabs below to move from one traveler to the next. Enter names exactly as they appear on your passports, and be sure to select Gender and indicate Birthdate for ALL travelers. You can enter each traveler's passport Information here if it is available or send it to us later.

Samurai Tours Mailing List

Each traveler also has the option to join our mailing list and receive monthly newsletters from Samurai Tours. To subscribe, click the Join Mailing List button, and enter the traveler's email address. Each traveler can unsubscribe at any time by following the unsubscribe instructions at the bottom of each newseltter announcement email.

No. 1
No. 2
No. 3
No. 4
No. 5
No. 6

Traveler No. 1

Be sure to enter each traveler's name exactly as it appears on their passport.

First Name

Gender Male Female

Passport Issuing Country

Last Name

Birthdate

Passport Number

Smoking Preference Smoking Non-smoking No Preference

Please list any health issues:

Please list any food allergies:

Please list any other allergies:

Please list any dietary restrictions (Please be as specific as possible):

Join Mailing List By clicking this button you agree to the terms stated above.
Email Address

Traveler No. 2

Be sure to enter each traveler's name exactly as it appears on their passport.

First Name

Gender Male Female

Passport Issuing Country

Last Name

Birthdate

Passport Number

Smoking Preference Smoking Non-smoking No Preference

Please list any health issues:

Please list any food allergies:

Please list any other allergies:

Please list any dietary restrictions (Please be as specific as possible):

Join Mailing List By clicking this button you agree to the terms stated above.
Email Address

Traveler No. 3

Be sure to enter each traveler's name exactly as it appears on their passport.

First Name

Gender Male Female

Passport Issuing Country

Last Name

Birthdate

Passport Number

Smoking Preference Smoking Non-smoking No Preference

Please list any health issues:

Please list any food allergies:

Please list any other allergies:

Please list any dietary restrictions (Please be as specific as possible):

Join Mailing List By clicking this button you agree to the terms stated above.
Email Address

Traveler No. 4

Be sure to enter each traveler's name exactly as it appears on their passport.

First Name

Gender Male Female

Passport Issuing Country

Last Name

Birthdate

Passport Number

Smoking Preference Smoking Non-smoking No Preference

Please list any health issues:

Please list any food allergies:

Please list any other allergies:

Please list any dietary restrictions (Please be as specific as possible):

Join Mailing List By clicking this button you agree to the terms stated above.
Email Address

Traveler No. 5

Be sure to enter each traveler's name exactly as it appears on their passport.

First Name

Gender Male Female

Passport Issuing Country

Last Name

Birthdate

Passport Number

Smoking Preference Smoking Non-smoking No Preference

Please list any health issues:

Please list any food allergies:

Please list any other allergies:

Please list any dietary restrictions (Please be as specific as possible):

Join Mailing List By clicking this button you agree to the terms stated above.
Email Address

Traveler No. 6

Be sure to enter each traveler's name exactly as it appears on their passport.

First Name

Gender Male Female

Passport Issuing Country

Last Name

Birthdate

Passport Number

Smoking Preference Smoking Non-smoking No Preference

Please list any health issues:

Please list any food allergies:

Please list any other allergies:

Please list any dietary restrictions (Please be as specific as possible):

Join Mailing List By clicking this button you agree to the terms stated above.
Email Address

Special Requests & Comments Please select the required number of rooms:
Single: Double: Triple:

Special Occasions
(For example, will you be celebrating any birthdays or anniversaries during the tour?) Any other requests or comments.