ARVTS REGISTRATION FORM

Print out this page, fill it out, and send with appropriate deposit to:

Assisted Recreation & Vacation Travel Services
40 Woodbridge Avenue
Sewaren, New Jersey 07077-1337

For further information, call (732) 636-6710 or e-mail arvts@ddanj.org.

You may register for more than one package at a time by printing and filling out multiple forms. Be sure to send all required deposits.

Name of Vacation Package: ______________________________________________________________

Date of Vacation Package: __________________________ Emergency Tel #________________________

Name of Travel Guest: _______________________________________ Phone #_______________________

Address: ______________________________________________________________ Email: ________________________

Does our guest require a wheelchair? Yes _______ No _______ Is a lift van required? Yes______ No______

If so, call for possible additional charges.

Contact Person or Agency, if applicable: _______________________________________________________________

Please Note:
Vacation guest must be in possession of a Photo ID from a government source (e.g., Dept. of Motor Vehicle Non Drivers License ID).

Registration & Deposit Deadlines:
Day Trips:
Payment in full upon registration one (1) month prior to date of excursion.

Packages Via Rail, Airplane, Cruise or Van:
50% deposit required with registration two (2) months prior to departure. Payment in full one (1) month prior to departure.