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2026 Breeze Travels Rhythm & Rio Group

Nov 5, 2026 to Nov 11, 2026

Brazil ~ Discover Rio: Culture, Coast & Carnival

Brazil Land Only Package (Double Occupancy) —

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Total —

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Primary Traveler

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		<field type="header" subtype="h2" label="Primary Traveler Full name"/>&#13;
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		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
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		<field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
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		<field type="text" label="Citizenship" name="citizenship" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Known Traveler Number (KTN) TSA Pre-Check" name="known-traveler-number-ktn-tsa-precheck" subtype="text" className="form-control"/>&#13;
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		<field type="date" required="true" label="Birthday" name="birthday" className="form-control"/>&#13;
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			<option label="Wheel Chair Assistance" value="wheel-chair-assistance">Wheel Chair Assistance</option>&#13;
			<option label="Handicap Accessible Room" value="handicap-accessible-room">Handicap Accessible Room</option>&#13;
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		<field type="text" label="Emergency Contact Name" name="website" subtype="text" className="form-control"/>&#13;
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			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Middle" value="middle">Middle</option>&#13;
			<option label="Window" value="window">Window</option>&#13;
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		<field type="text" required="true" label="What is your departure City" name="what-is-your-departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your departure State" name="what-is-your-departure-state" subtype="text" className="form-control"/>&#13;
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		<field type="checkbox-group" label="Please advise if you and your roommate need separate invoices (If yes select 1 traveler)" description="If choosing yes to separate invoices  you are responsible for your roommate paying their balance in full." inline="true" name="please-advise-if-you-and-your-roommate-need-separate-invoices">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
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		<field type="date" label="Roommate #2 Birthdate" name="roommate-1-birthdate" className="form-control"/>&#13;
		<field type="text" label="Roommate #2 E-mail Address" name="text-1651441749137" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Roommate&amp;nbsp; #2 Cell Phone Number" name="text-1651441733700" subtype="text" className="form-control"/>&#13;
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			<option label="King" value="king">King</option>&#13;
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			<option label="Beach and Water" value="beach-and-water">Beach and Water</option>&#13;
			<option label="Adventure Activities" value="adventure-activities">Adventure Activities</option>&#13;
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Terms & Conditions

We are Breeze Travels and are excited to help you with your travel. The following terms & conditions (the "Agreement") describe what you can expect from us. The terms "we", "us", and "our" refer to Breeze Travels and the term "you" refers to the individual who signs this agreement. Before traveling, please check if there are any restrictions due to your felony conviction. It’s wise to consult the US embassy of your destination to confirm your travel eligibility.

Click to sign

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		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
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		<field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/>&#13;
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			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle" value="opposite aisle">Opposite aisle</option>&#13;
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			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
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			<option label="Small" value="Medium">Small</option>&#13;
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		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
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			<option label="Window" value="window">Window</option>&#13;
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			<option label="Economy" value="value">Economy</option>&#13;
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			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
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			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
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			<option label="Small" value="Medium">Small</option>&#13;
			<option label="Large" value="1X Large">Large</option>&#13;
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I agree to the following terms & conditions. Thank you for your purchase with Breeze Travels LLC. To complete your transaction and confirm your arrangements, your submission of this authorization form is required. Charges are payable ONLY to the hotel, resort, tour operator, cruise line or other travel supplier designated by the above entity. I certify that I am authorized to use this credit / debit card and that I am able to make charges using this credit / debit card. I will not dispute the payment with my credit card company as long as the transaction corresponds with the terms indicated above. This payment authorization is for the goods and services described above. By my submission of this form, I give authorization to Breeze Travels LLC and the travel vendor being used to debit my credit / debit card for amounts listed above ONLY.
Breeze Travels LLC is registered with the State of Florida as a Seller of Travel Ref. No. ST41448

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2026 Breeze Travels Rhythm & Rio Group

Nov 5, 2026 to Nov 11, 2026

Brazil ~ Discover Rio: Culture, Coast & Carnival

Brazil Land Only Package (Double Occupancy) —

—

Total —

Due now —

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2026 Breeze Travels Rhythm & Rio Group

Nov 5, 2026 to Nov 11, 2026

Brazil ~ Discover Rio: Culture, Coast & Carnival

Brazil Land Only Package (Double Occupancy) —

—

Total —

Due now —

Continue to traveler info

2026 Breeze Travels Rhythm & Rio Group

Nov 5, 2026 to Nov 11, 2026

Brazil ~ Discover Rio: Culture, Coast & Carnival

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2026 Breeze Travels Rhythm & Rio Group

2026 Breeze Travels Rhythm & Rio Group

Nov 5, 2026 to Nov 11, 2026

Brazil ~ Discover Rio: Culture, Coast & Carnival

2026 Breeze Travels Rhythm & Rio Group

Nov 5, 2026 to Nov 11, 2026

Brazil ~ Discover Rio: Culture, Coast & Carnival