PRIME 2011 KAUAI ACTIVITIES

SECURE RESERVATION & PAYMENT FORM

Aloha Holidays, 438 Hobron Lane Suite 109, Honolulu, HI 96815
Telephone: 808-943-0999 Fax: 808-942-4573
Email: reservations@alohaholidayshawaii.com

(If you prefer, you may print the Reservation Form and fax it to 808-942-4573.)
Fields with (*) are mandatory. A confirmation will follow. If you are signing up only for
Complimentary items, fill in the credit card information as follows: Visa, #0000000000000000
and expiration date as: 00/00.

*Day Phone: Evening #:
Fax: Cell Phone:
*Email:
Country: *Zip/Post:

	Check the Activity to be reserved, enter the date and # persons for each activity. Total the prices for payment.	Day/Date	#Pax	P/Person Rate
	1. Kipu Raft Snorkel Tour (Complimentary)	Sun, Jun 12		Complimentary
	2. North Shore - Hanalei Mini-coach Tour (Complimentary)	Sun, Jun 12		Complimentary
	3. Ultimate Kauai Helicopter Tour (Special Rate) - 1pm flight	Sun, Jun 12		$194.00
*Total Amount: ()** Calculate your choices and enter the total in the box provided. Enter "$0.00" in Total Amount if only choosing Complimentary activities. Cancellations for paid activities incur a 15% fee, full charge if cancelled within 48 hours. Rates include state and harbor taxes. Subject to change.


Comments:	(Please include the names of all attendees on the activities selected and any additional information that may be pertinent). Please add body weights for Helicopter Tours.
Enter your Credit Card information below. *Note: Blue fields with a star () are required**
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*Cardholder Name: ()**
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*Country: ()**		*Zip/Postal: ()**
*Type of Credit Card: ()**	*Num.: () Expires: ()* mm/yy
Press the Submit button only once to prevent overcharging.

(Aloha Holidays Ltd. does not share customer information with anyone, anytime, for any reason whatsoever.)
Copyright 2011 - Aloha Holidays Ltd.