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2026 Panama Holiday Weekend

Feb 12, 2026 to Feb 16, 2026

Double Occupancy Hotel & Transfer Only —

—

Total —

Due now —

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Enter traveler information

Primary Traveler

INCOMPLETE

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		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<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;
		<field type="text" label="Preferred name (nickname)" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary email address" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Information"/>&#13;
		<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;
		<field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of birth" name="birthday" className="form-control"/>&#13;
		<field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Emergency Contact Information"/>&#13;
		<field type="text" label="Full name" name="emergency-contact-full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="emergency-contact-phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Relationship to you" name="emergency-contact-relationship" subtype="text" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="text" label="Text Field" name="text-1685484024103" value="Roommate&#39;s Name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Text Field" name="text-1685484086448" value="How many Trips have you had with BWT/DDT?" subtype="text" className="form-control"/>&#13;
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Terms & Conditions

We are BWT . 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 BWT . and the term "you" refers to the individual who signs this agreement.

Click to sign

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<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;
		<field type="text" label="Preferred name (nickname)" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary email address" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Information"/>&#13;
		<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;
		<field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of birth" name="birthday" className="form-control"/>&#13;
		<field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Emergency Contact Information"/>&#13;
		<field type="text" label="Full name" name="emergency-contact-full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="emergency-contact-phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Relationship to you" name="emergency-contact-relationship" subtype="text" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="text" label="Text Field" name="text-1685484024103" value="Roommate&#39;s Name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Text Field" name="text-1685484086448" value="How many Trips have you had with BWT/DDT?" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
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<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<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;
		<field type="text" label="Preferred name (nickname)" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Primary email address" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Information"/>&#13;
		<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;
		<field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of birth" name="birthday" className="form-control"/>&#13;
		<field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Emergency Contact Information"/>&#13;
		<field type="text" label="Full name" name="emergency-contact-full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="emergency-contact-phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Relationship to you" name="emergency-contact-relationship" subtype="text" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="text" label="Text Field" name="text-1685484024103" value="Roommate&#39;s Name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Text Field" name="text-1685484086448" value="How many Trips have you had with BWT/DDT?" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

Continue to traveler info

Credit Card Authorization

1

Select the amount you would like to authorize:

1

Select the amount you would like to authorize:

Authorize deposit

Final payment of $475.00 is due on January 5, 2026

$0.00

Authorize full amount

$475.00

2

Please add a card to authorize:

2

Please add a card to authorize:

3

Sign and agree to the terms and conditions:

3

Sign and agree to the terms and conditions:

By signing below, I authorize BWT . to charge the credit card provided herein.

Click to sign

2026 Panama Holiday Weekend

2026 Panama Holiday Weekend

Feb 12, 2026 to Feb 16, 2026

Double Occupancy Hotel & Transfer Only —

—

Total —

Due now —

Continue to traveler info

Our system uses SSL encryption, which is the same technology banks use to protect sensitive information.

2026 Panama Holiday Weekend

Feb 12, 2026 to Feb 16, 2026

Double Occupancy Hotel & Transfer Only —

—

Total —

Due now —

Continue to traveler info