Himakajima Island one-day tour with seafood lunch Inquiry Form

Tour name		Himakajima Island one-day tour with seafood lunch
Departure date
Number of participants		Adults: Children:
Representative	Name	First Name: Last Name:
	Sex	Male Female
	Age
	Nationality
Contact phone number
Accommodation
Email address
Companion 1	Name	First Name: Last Name:
	Sex	Male Female
	Age
	Nationality
Companion 2	Name	First Name: Last Name:
	Sex	Male Female
	Age
	Nationality
Companion 3	Name	First Name: Last Name:
	Sex	Male Female
	Age
	Nationality
Companion 4	Name	First Name: Last Name:
	Sex	Male Female
	Age
	Nationality
Payment		Online settlement with a credit card (A lump-sum payment only.) * We accept credit card payment only.
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