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Application form page (from April to September)

Camper accommodation plan

Plan name ※required
Representative full name ※required
Furigana ※required
The date of birth ※required
/ /   
Sex ※required
Phone number ※required
(Half-width number)

※Please input cell phone number as the emergency contact information.
E-mail address ※required


※A lot of cases which an email does not reach to an address of iCloud are confirmed. I am sorry to trouble you, but I would appreciate your registering an address except iCloud as much as possible.
※There is the possibility divided in two by ha junk email to Gmail. Please confirm it to a junk email box.
Address ※required
 
The number of participants (adult) ※required

※I become an adult from junior high student or more.
The number of participants (primary schoolchild) ※required
The number of men ※required

※Please choose the number of men who are older than a primary schoolchild.
The number of women ※required

※Please choose the number of women who are older than a primary schoolchild.
The departure date (from July to September) ※required

※An exclusion day: 8/8-8/18
The Nagasaki Port start on a voyage time (surface mail) ※required

※①Ship, ⑴⑵ high-speed in -③ in Jetfoil, 1⃣ - 3⃣ are ferries
※A Jetfoil, the high-speed ship is adult 3,000 yen (dwarf 1,500 yen) up per one way one
The port of upper Goto start on a voyage time (surface mail) ※required

①Ship, ⑴⑵ high-speed in -③ in Jetfoil, 1⃣ - 3⃣ are ferries
※A Jetfoil, the high-speed ship is adult 3,000 yen (dwarf 1,500 yen) up per one way one
Participation having reliable pack or not ※required

※The reliable pack is insurance plan when I caused an accident.
※For an emergency, I recommend that I join it.
※When you join it, on the day please pay in the field.
※On the day I can join it in the field even if I choose "I do not join it" at present.
Change to 3 days and 2 nights ※required
※As an additional charge incurs when I change it, please confirm list of charges.
Please input to one person about the companion.
Companion 1: Full name ※required
Companion 1: Furigana ※required
Companion 1: The date of birth ※required
/ /   
Companion 1: Sex ※required
Kyushu Syosen
〒850-0035
16-12, Motofunamachi, Nagasaki-shi, Nagasaki
TEL.0570-017510
1.Passenger regular line business
2.Harbor express service
3.Transportation business
4.Travel agency
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