Tour Date         
Requested:       
                        Date of Arrival on Kauai:  
Prefer to take Tour:   Morning Afternoon
Kauai Accommodations:  
                          Passenger Names Weight Height
               1.
               2.
               3.
               4.
               5.
               6.
   
 


 
  Name: 

  • Street: 
     City:   •
     Country: 
   Zip: 
   Cell Phone: 
   Email: 
   
  Visa  Month  Year      
  MC AMEX    How did you find us?
 

 Card Number

 CVS
                                    Notes / Questions: