Farrios Travel Adventures

Bella Italia Escape / November 14 - 22, 2026

Client Intake Form

Number of Travelers in Your Party

Traveler 1 Information

Traveler 1 - First Name

Traveler 1 - Middle Name

Traveler 1 - Last Name

Traveler 1 - Date of Birth

Month

Day

Year

Traveler 1 Address

Multi-line address

Country/Region

Address

City

Zip / Postal code

Traveler 1 - Email

Traveler 1 - Phone

Traveler 1 - Passport Status

Traveler 1 - Passport Number

Traveler 1 - Passport Expiration

Accessibility / Assistance Requests - Does Traveler 1 have any specific needs or requests? (Select all that apply)

Traveler 1 - Special Requests

No, not applicable

Yes – Room accommodations needed for mobility or accessibility purposes (e.g., CPAP, wheelchair-accessible, walker support) - provide details below.

Yes – Specific dietary requirements or food allergies (e.g., vegetarian, vegan, gluten-free, dairy-free, nut allergy, etc.) - provide details below.

Other – provide details below

Traveler 1 - Provide Special Request Details

Traveler 2 Information

Traveler 2 - First Name

Traveler 2 - Middle Name

Traveler 2 - Last Name

Traveler 2 - Date of Birth

Month

Day

Year

Traveler 2 address - is the same as Traveler 1

Multi-line address

Country/Region

Address

City

Zip / Postal code

Traveler 2 - Email

Traveler 2 - Phone

Traveler 2 - Passport Status

Traveler 2 - Passport Number

Traveler 2 - Passport Expiration Date

Accessibility / Assistance Request - Does Traveler 2 have any specific needs or requests? (select all that apply)

Traveler 2 - Special Requests

No, not applicable

Yes – Room accommodations needed for mobility or accessibility purposes (e.g., CPAP, wheelchair-accessible, walker support) - provide details below.

Yes – Specific dietary requirements or food allergies (e.g., vegetarian, vegan, gluten-free, dairy-free, nut allergy, etc.) - provide details below.

Other – provide details below

Traveler 2 - Provide Special Request Details

Accommodations

What type Accommodations are you requesting? NOTE: Single rooms are limited in availability and are assigned based on first-come, first-served and tour operator confirmation.

Double/Twin Occupancy Rate: $2,339 pp after $500 discount. Regular $2,839 (max 2 persons per room)

Single Occupancy Rate: $2,789 pp after $500 discount. Regular $3,289 (single person per room) - Limited availability/Not Guaranteed - If single supplement is waived $2,339 (limited/not guaranteed)

Triple Occupancy Rate: $2,339 pp after $500 discount. Regular $2,839 (max 3 persons per room, no additional discount for triple) - Limited Available/Not Guaranteed

Additional Hotel Nights

Extended Stays – Looking to explore a bit more on your own? You may add extra hotel nights for an additional cost.

Pre-Tour Hotel Nights

From Date

To Date

Post-Tour Hotel Nights

From Date

To Date

Airfare Booking Preference

How would you like to arrange your airfare?

I will book my own airfare

I would like the Tour Operator (Globus) to book my airfare -transfers included

I would like Farrios Travel Adventures to book my airfare

Transfers

No, I do not need airport transfers

Yes, I would like to purchase Arrival Transfer (Venice) – $55 pp

Yes, I would like to purchase Departure Transfer (Pompeii) – $55 pp

Select Traveler(s) Requiring Airport Transfers

Travel Insurance

Please be Aware: Your personal health insurance may not cover you while traveling abroad. You are responsible for any medical or related costs, including treatment or evacuation.

ACCEPT - I would like to purchase a travel insurance and understand the benefits. - $289.00 pp

DECLINE - I do not wish to purchase Travel Insurance and understand the risks.

Additional Traveler Information

Are there additional Travelers in your Travel Party?

Yes

Additional Information

I certify that the information provided is complete and accurate, and I acknowledge that it will be used for booking and travel documentation purposes

Farrios Travel Adventures

Bella Italia Escape / November 14 - 22, 2026

Client Intake Form

Number of Travelers in Your Party

Traveler 1 Information

Traveler 1 - First Name

Traveler 1 - Middle Name

Traveler 1 - Last Name

Traveler 1 - Date of Birth

Month

Day

Year

Traveler 1 Address

Multi-line address

Country/Region

Address

City

Zip / Postal code

Traveler 1 - Email

Traveler 1 - Phone

Traveler 1 - Passport Status

Traveler 1 - Passport Number

Traveler 1 - Passport Expiration

Accessibility / Assistance Requests - Does Traveler 1 have any specific needs or requests? (Select all that apply)

Traveler 1 - Special Requests

No, not applicable

Yes – Room accommodations needed for mobility or accessibility purposes (e.g., CPAP, wheelchair-accessible, walker support) - provide details below.

Yes – Specific dietary requirements or food allergies (e.g., vegetarian, vegan, gluten-free, dairy-free, nut allergy, etc.) - provide details below.

Other – provide details below

Traveler 1 - Provide Special Request Details

Traveler 2 Information

Traveler 2 - First Name

Traveler 2 - Middle Name

Traveler 2 - Last Name

Traveler 2 - Date of Birth

Month

Day

Year

Traveler 2 address - is the same as Traveler 1

Multi-line address

Country/Region

Address

City

Zip / Postal code

Traveler 2 - Email

Traveler 2 - Phone

Traveler 2 - Passport Status

Traveler 2 - Passport Number

Traveler 2 - Passport Expiration Date

Accessibility / Assistance Request - Does Traveler 2 have any specific needs or requests? (select all that apply)

Traveler 2 - Special Requests

No, not applicable

Yes – Room accommodations needed for mobility or accessibility purposes (e.g., CPAP, wheelchair-accessible, walker support) - provide details below.

Yes – Specific dietary requirements or food allergies (e.g., vegetarian, vegan, gluten-free, dairy-free, nut allergy, etc.) - provide details below.

Other – provide details below

Traveler 2 - Provide Special Request Details

What type Accommodations are you requesting? NOTE: Single rooms are limited in availability and are assigned based on first-come, first-served and tour operator confirmation.

Double/Twin Occupancy Rate: $2,339 pp after $500 discount. Regular $2,839 (max 2 persons per room)

Single Occupancy Rate: $2,789 pp after $500 discount. Regular $3,289 (single person per room) - Limited availability/Not Guaranteed - If single supplement is waived $2,339 (limited/not guaranteed)

Triple Occupancy Rate: $2,339 pp after $500 discount. Regular $2,839 (max 3 persons per room, no additional discount for triple) - Limited Available/Not Guaranteed

Additional Hotel Nights

Extended Stays – Looking to explore a bit more on your own? You may add extra hotel nights for an additional cost.

Pre-Tour Hotel Nights

Do not include your scheduled tour nights when selecting pre- and/or post-tour dates.

Post-Tour Hotel Nights

Do not include your scheduled tour nights when selecting pre- and/or post-tour dates.

Airfare Booking Preference

How would you like to arrange your airfare?

I will book my own airfare

I would like the Tour Operator (Globus) to book my airfare -transfers included

I would like Farrios Travel Adventures to book my airfare

No, I do not need airport transfers

Yes, I would like to purchase Arrival Transfer (Venice) – $55 pp

Yes, I would like to purchase Departure Transfer (Pompeii) – $55 pp

Select Traveler(s) Requiring Airport Transfers

Travel Insurance

Please be Aware: Your personal health insurance may not cover you while traveling abroad. You are responsible for any medical or related costs, including treatment or evacuation.

ACCEPT - I would like to purchase a travel insurance and understand the benefits. - $289.00 pp

DECLINE - I do not wish to purchase Travel Insurance and understand the risks.

Additional Traveler Information

Are there additional Travelers in your Travel Party?

Yes

Additional Information

I certify that the information provided is complete and accurate, and I acknowledge that it will be used for booking and travel documentation purposes