Laguna Beach Resort Information Request

Fields marked with an (*) are required.

Where did you hear about Laguna Beach Resort*?
First Name*:
Last Name*:
Email*:
Phone*:
Mailing Address*:
City*:	State*:    Zip Code*:
Country*:
Date of Arrival*:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2006 2007 2008
Date of Departure*:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2006 2007 2008
Are these dates flexible?	Yes No
Comments:
Number of Adults traveling*:
Number of Children Traveling*:	(Ages 3-10 1/2 price staying in the same room as an adult)
Number of divers in party*:
Number of non-divers in party*:
Bungalow Type (2 people per Individual or Duplex bungalow):
Duplex Bungalow Individual Bungalow Family Cabin
Type of Bedding Prefered: (• All bedding preferences are considered, however bedding type is not guaranteed until arrival.)
2 Full-Size Beds 1 King
Would you like for us to search International Air for you?	Yes (If yes, please complete the section at the bottom) No
Are you interested in us booking your local Air into Utila?	Yes No
Would you like for us to send you a brochure?	Yes No
If you selected Yes for us to search International Air for you, please fill out the section below. If not, you can go to the bottom of the form and click "Submit".
International Air Quote Form
Number of Passengers:
Adult Passengers:
Child Passengers:	(Ages 2-11)
Infant Passengers:	(Under 2 years of age)
• • For Groups of 10 or more, contact Utila Tours Directly at 1-800-668-8452 to arrange group air. • •
Departure Airport:
First Choice*:
Second Choice:
Date of Departure*:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2004 2005 2006 2007
Date of Return*:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2004 2005 2006 2007
Are these dates flexible?	Yes No
Comments: