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Jass Casino Tours
Reservation Form
* - Required field

Trip date*         Hotel*

Accommodations:  1 Bed   2 Beds   Smoking   Non-Smoking   Handicapped

Last Name*     First Name/s*

Address* Apt./Suite

City*   State*   Zip Code*    E-mail

Home Telephone*     Work Telephone ext.

I/we will board the bus at:     *Date of Birth


I / We will be sharing a room with:( Please fill out this portion if other than spouse)

Last Name     First Name

Address   Apt./Suite

City   State   Zip Code   E-Mail

Home Telephone     Work Telephone ext.

I/we will board the bus at:    *Date of Birth

complete this form, print and mail to:
Jass Tours
105 Emerald Way West
Granite City, IL  62040

 

Price per person:

        # of people:

    Total amount:

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