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 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.

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

Traveler No. 1

First Name

Gender Male Female

Last Name

Birthdate

Traveler No. 2

First Name

Gender Male Female

Last Name

Birthdate

Traveler No. 3

First Name

Gender Male Female

Last Name

Birthdate

Traveler No. 4

First Name

Gender Male Female

Last Name

Birthdate

Traveler No. 5

First Name

Gender Male Female

Last Name

Birthdate

Traveler No. 6

First Name

Gender Male Female

Last Name

Birthdate

Contact Information

Address Line 1
Address Line 2
Address Line 3

City

Postal Code

Daytime Phone

State

Country

Evening Phone

Email Address

Tour Selection Tour Name and Date

Special Requests & Comments Smoking Preference Smoking Non-smoking No Preference

Dietary Requests Room Requests
(For example, if there are three in your group, do you want one room or two?) Special Occasions
(For example, will you be celebrating any birthdays or anniversaries during the tour?) Any other requests or comments.