Reservation Form

In order to place your reservation, fill out all fields of the form below.

We will send a confirmation and the next steps to follow within 2 Business days.

 
* CHOOSEN TRIP
(choose one or more trips)
 

Hawaii Expedition                                                 $ 985 + Airfare

Feb 4 – 11 (Trip Closed)

Mar 3 – 10 (Trip Closed)

Mar 24 – 31 (Trip Closed)





Please choose accommodations:
Quadruple Occupancy (2 per bed)
       Included   
Double Occupancy (1 per bed)
      ADD $388.00

Please choose accommodations:
Quadruple Occupancy (2 per bed)
       Included   
Double Occupancy (1 per bed)
      ADD $336.00
Please choose accommodations:
Quadruple Occupancy (2 per bed)
       Included   
Double Occupancy (1 per bed)
      ADD $516.00
Please choose accommodations:
Quadruple Occupancy (2 per bed)
       Included   
Double Occupancy (1 per bed)
      ADD $258.00
Please choose accommodations:
Quadruple Occupancy (2 per bed)
       Included   
Double Occupancy (1 per bed)
      ADD $488.00
Please choose accommodations:
Quadruple Occupancy (2 per bed)
       Included   
Double Occupancy (1 per bed)
      ADD $610.00

New York City                                                        $ 735 + Airfare

Apr 7 – 11 (Trip Closed)

Apr 28 – May 2






N.York City and Washington D.C.                        $ 1130 + Airfare

Apr 7 – 14 (Trip Closed)

Apr 28 – May 5






California Adventure                                           $1090 + Airfare

Mar 10 - 17 (Trip Closed)

 

 

 





West Coast Trip                                                  $2050 + Airfare

June 10 – 23

 

 





East Coast Trip                                                  $ 1980 + Airfare

June 7 – 20

 

 






Chicago Trip                                                     $ 355

April 20-22 (Trip Closed)

YOUR INFORMATION
 
You are *:

Exchange Student
Host sibling
Friend
First Name *:
Last Name *:
Nickname:
Gender*:
Male      Female
Date of birth *:

   

Passport number*:
Country of Origin*:
E-mail*:
Cell Phone Number (if applicable):
Exchange year*:
2011  2011/2012   2012
YFU District *:
 

HOST COUNTRY INFORMATION
   
Host parent 1* (Name, Last Name):
Host parent 2 (Name, Last Name):
Address*:
City*:
State*:
Other

Host Country *:

ZIP Code *: 

Host Family Telephone*
Host Family Cell Phone
Host family e-mail address:
 

YOUR HOME COUNTRY INFORMATION
   
Address*:
City*:
State/Province*:
Country*
ZIP (Postal Code)
Home Phone: 
 
Cell Phone:
Natural Parents (Guardian) Names*:
 
E-mail address:
 
MEDICAL INFORMATION
Medical insurance company:
Policy/I.D. number:
Are you allergic to anything or take any medication?*
Yes                   No
If yes, please describe:
Do you take any medications?*
Yes                   No
If yes, please describe:
Will you bring medications with you?


GENERAL INFORMATION
   
Do you have any dietary restrictions? (vegetarian, vegan, etc…) *
Yes                   No
If yes, please describe:
Do you smoke? *
Yes                   No
Can you swim? *
Yes                   No
Have you had swimming lessons?*
Yes                   No
Payment form*:
International wire transfer
Money Order
Personal check
Credit Card via Pay Pal
T-shirt size*:
S  M   L  XL


* How did you hear about YFU Tours with Belo USA Travel?

 

* I have read and I do agree with all the terms of this trip's general conditions (click here).

* This information is mandatory