ACCESSIBILITY ACCOMMODATION REQUEST FORM

In order to provide you with the best accessible cruise experience possible, please submit the Guest Special Needs Form at time of booking but no later than 30 days prior to sailing, except for sign language interpreting requests which must be submitted 60 days prior to sailing. This will allow us to make the necessary arrangements for your requested accommodations.

Sensitive personal data- We collect details relating to your health or medical conditions, including details of any accessibility requirements, allergies or other health-related requests.

We also may collect details of your meal preferences which may tell us about allergies or other dietary requirements, or potentially indicate your religion or beliefs. When you provide this information to us, this enables us to understand your requirements so that we can work with our onboard team and suppliers to best meet your needs.

For more information, you can read our global privacy policy on any website operated by us. This sets out your rights to access, rectification and erasure of your data and contact details for a revocation of your consent.

I hereby declare that I have read and understood this consent declaration and that.

1. I consent to the processing of data to adapt the cruise to my needs

Yes No

Note: Your request cannot be processed if you do not accept our data privacy policy.

2. I consent to the transfer of data to tour operators in third countries outside the EU / EEA

Yes No

Note: Your request cannot be processed if you do not accept our data privacy policy.

General Information

*Required information

*First name: *Last name: *Email address:

*Phone number: *Country of residence:

*Ship: *Sail date: *Reservation number:

I do not yet have a sailing booked

I have flights

Arrival in Port

Date: Airport Code:

Airline Code: Flight Number:

• Note: if your flight has connections, please only share the information for the last leg of your journey.

Departure from Port

Date: Airport Code:

Airline Code: Flight Number:

Booking Accessible Stateroom?

I require an accessible stateroom because I have a mobility disability or other disability that requires the use of the accessible features that are provided in the stateroom

What accommodations do you need?

Mobility Accommodations

Pier Assistance

Wheelchair assistance in the terminal including boarding and leaving the ship.

Do you require accessible transfers to/from the airport or pre-cruise hotel?

Yes No

• Note that you must purchase transfers prior to notifying us that you need accessible transportation. There is no additional fee for the accessible transportation
• May not be available in all ports where your cruise beings and ends.

Commode chair

None Standard Wheeled

Raised Toilet Seat

Yes No

Shower Stool

Check here if you would like to be contacted by our Accessible Shore Excursion Team?

Bringing Wheelchair

Manual/Power:

Collapsible/Non-collapsible:

Width (inches)

Length (inches)

Height (inches)

Combined height (inches)

Combined weight (inches)

Bringing Mobility Scooter

Folding/Non-folding:

Battery Type:

Width (inches)

Length (inches)

Height (inches)

Combined height (inches)

Combined weight (inches)

Other mobility accommodation requests

Dietary Accommodations

Specific food allergies

Other medical/disability-related dietary needs:

Note that we are not able to accommodate requests for preferred food items or brands unless they are specifically required as part of a medically-prescribed diet or indicated due to a specific sensory disability. We do not provide alternative food options due to dietary allergies.

Service Dog

I have a service dog that will be sailing with me

• Check our SVAN Code of Conduct by clicking HERE

• You will need to agree to all requirements contained in the Service Dog Code of Conduct. Please download and review this document carefully to ensure you and your service dog can meet all behavioral expectations

• Note: Guests are responsible for obtaining all required documents for the dog to depart the ship in ports of call and at final destination.

• Note that ONLY service dogs are allowed to sail. Emotional support dogs/animals are not permitted onboard.

Autism/Developmental Disabilities

Please list all necessary accommodations.

Deaf/Hard of Hearing Accommodations

Sign Language Interpreting Services are available on cruises to/from U.S. and Canada only. Request must be made 60 days prior to sailing

ASL Interpreters (for US/Canada sailings only)

Pro Tactile ASL?

Yes No

Visual/Tactile Alert System Kit (ADA Kit) in stateroom

Blind/Low-vision Accommodations

Blind (optional)

Note: While this information is optional, it is helpful for the ship so that assistance may be provided to guests who are blind during the cruise.

Front/close-in seating at entertainment venues

Large print material

Qualified readers

Audio Describer services

Requests for audio describers must be received at least 60 days prior to sailing. Audio Describer services are only available on cruises to/from the US and Canada.

Bringing equipment/medications

CPAP

Medical refrigerator/sharps container

Additional Information

Other (Walker, crutches, etc)

Dialysis

Peritoneal:

• Note that we cannot accommodate guests currently receiving hemodialysis treatment.

Other

Extension Cord

If your needs aren’t covered above, please let us know how we can accommodate you during your cruise.

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   www.celebritycruises.com