Intergalactic Travel Application Form

1- Personal Information section

This form is for a futuristic travel agency that organizes trips across the galaxy.
Applicants provide comprehensive information for their adventurous journey through space.

Full Name

Email ID

Emergency Contact

Enter your age [14 min - 65 max]

Birthday


Select your preferred spacesuit color

2- Travel Preference Section

Select your desired planets and galaxies to visit

Mars Jupitor Saturn Neptune Pluto Mercury

Cabin Class Choices

Economy Business Galactic Suite

Select your desired gravity level in spacecraft:


(0% min - 60% max)

Select your preferred meals:

3- Intergalactic Passport Upload Section

Attach your passport or intergalactic ID


4- Health and Safety Section

Select below if you have any space allergies

Moon Dust Solar Flares Saturn Sensitive Eyes Saturn Dust Jupitor Nuts Pluto pollens

If you have any special Medical Requirements, please write here


5- Legal Agreements and Consents Section

Do you agree with the risk of injury during space travel

Do you agree with space sickness waiver policy

6- Signature Field

If you have any extra requests or fun space travel wishes, please write here