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Pennsic at Coopers Lake
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Mega Bus Round Trip
Fill out the form below, please include accurate arrival/departure information and the estimated amount of luggage.
Number of Passengers
1
2
3
4
5
6
7
8
9
10
more- specify in message below
Checked Bags
none
1
2
3
4
5
more- specify in message below
Carry-on Bags
none
1
2
3
4
5
more- specify in message below
Client First Name
Client Last Name
If you are booking for someone else, please fill out your name here:
First Name
Last Name
Relation to Client
Phone/Cell Phone
Number of Passengers:
1
2
3
4
5
More- specify in message below
Street Address
City
Zip
Phone/Cell Phone
Email
Arrival Month
January
February
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Day
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Year
2011
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2013
Arrival Time
AM/PM
AM
PM
City Coming From
Departure Month
January
February
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December
Day
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Year
2011
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DepartureTime
AM/PM
AM
PM
City Going To
Wheelchair Assistance Requested
No
Yes
Infant Seat
No
Yes- 1
Yes- 2
Yes- 3
Toddler Seat
No
Yes- 1
Yes- 2
Yes- 3
Booster Seat
No
Yes- 1
Yes- 2
Yes- 3
Other Specific Requests/Concerns:
More information on special assistance/child seats