W&L Forms Builder

Washington and Lee University
Lifelong Learning

ICELAND:
Fire and Ice, 8-day Sail
(JUNE 17-24, 2025)

* GUEST 1: Full Name as it appears on your passport (First / Middle / Last)

* Preferred Name for name badge:

MAILING ADDRESS:

* Street:

* City, State & Zip:

* Email:

* Mobile Number:

* Birthdate and Age:

* W&L Affiliation (Class Year, Parent (Year), Friend):

If you have any mobility concerns, please list here:

EMERGENCY CONTACT INFORMATION:

Name & phone number:

GUEST 2: Full Name as it appears on your passport (First / Middle / Last)

Preferred Name for name badge:

MAILING ADDRESS (if different than listed under Guest 1):

Street:

City, State & Zip:

Email:

Mobile Number:

Birthdate and Age:

W&L Affiliation (Class Year, Parent Year, Friend):

If you have any mobility concerns, please list here:

EMERGENCY CONTACT INFORMATION:

Name & phone number:

If you are traveling with others not listed on this form, please provide their name(s):

Will you be celebrating a special event during the trip (birthday, anniversary, etc.)? Please provide the date.

Cabin Category
First Choice:

Cabin Category
Second Choice:

Bed Arrangement:

Single (1 bed)

Twin Room (2 beds)

Double Room (1 bed)

Share with roommate assigned by Lindblad

Please check here if you would like to join the pre-tour extension:

Pre-Tour to Reykjavik's Golden Circle & Blue Lagoon

Preferred Payment Method:

Credit Card

Check (make payable to LINDBLAD EXPEDITIONS and send to W&L)