Panoram wine tours

Registration Form – 1 Traveler 

You're just a few clicks away from booking an amazing vacation you'll never forget! 

Please ensure you fill out this form in its entirety. If you experience difficulties, please email acebrian@panoramimports.com


Full Name *
Full Name
Name as it appears on your passport.
Phone *
Phone
Address *
Address
Date of Birth *
Date of Birth
Gender *
Do you have any dietary restrictions? *
(Ex: gluten allergy, lactose intolerance, shellfish allergy, etc.)
Do you have any health or fitness conditions we need to be made aware of? *
(Ex: heart condition, diabetes, weak knees, difficulty climbing stairs, allergies, wheel chair, etc.)
(Ex: heart condition, diabetes, weak knees, difficulty climbing stairs, allergies, wheel chair, etc.)
Do you require any special hotel room requirements? Please check all that apply.
We will do everything in our power to ensure the below requests are met. However, these will be based on the availability at the boutique hotels we are staying.
Any payment to Panoram Tours/Panoram Catering, LLC constitutes you have read and accept our terms and conditions, and therefore confirms your agreement of this booking as a contract that is binding on the parties and their respective heirs, representatives and assigns.