The Omega Letter Israel Tour Sign Up Form
TRAVEL AND LEARN, INC.
“The Modern Miracle of Israel”
Tour to Israel
March 21 - 29, 2009
TRAVEL RESERVATION FORM/APPLICATION
Please complete this entire form and return, together with your $1,500 check per person tour deposit, to Travel & Learn, Inc. 439 Lowell Lane, Richardson, Texas 75080 by November 2, 2008. Final payment (which will include the final airfare cost including taxes and fees, approximately $2,100.00) due on January 12, 2009.
PLEASE NOTE: The name on the registration form must be as it appears on your passport. If you do not have a passport at the time of registration please mark the appropriate box and apply for one as soon as possible. Processing times have been running several months. If more than one family member travels, each traveler must complete and sign a separate form. Please notify us if you are not a US Citizen in order to determine whether or not you require a visa.
NAME (as it appears on the passport):________________________________________________________
ADDRESS:_______________________________________________________________________________
PHONE: (day)_______________________(evening)______________________(cell) ____________________
EMAIL: (primary)_______________________________________(alternate)__________________________________
PASSPORT INFORMATION: (number)_________________________(date and place of issue)_____________________
(expiration date)___________________(issued by)________________________________
BIRTH DATE AND PLACE:____________________________________________________________________________
AMOUNT ENCLOSED:________________________________________________________________________________
ALTERNATE DEPARTURE AIRPORT? If yes, please specify:_______________________________________________
Flights for this tour depart from JFK
SINGLE SUPPLEMENT? If yes, please specify:___________________________________________________________
TRIP CANCELLATION INSURANCE? ($200.00 additional due at the time of first payment)_______________________
Description of benefits attached
ANY OTHER REQUESTS/PREFERENCES? ______________________________________________________________
(We will do our best to accommodate them)
I HAVE RECEIVED AND READ THE “TERMS AND CONDITIONS” ATTACHED TO THIS APPLICATION (EXHIBIT A). BY SIGNING BELOW I ATTEST THATHE INFORMATION ABOVE TRUE AND CORRECT AND THAT I AGREE WITH THE TERMS AND CONDITIONS GOVERNING THIS TOUR.
NAME (printed)________________________________________SIGNATURE___________________________________
DATE:_______________________________________________
TERMS AND CONDITIONS
1. GENERAL
As consideration for the acceptance of the undersigned as a participant in the trip to Poland and Israel tour entitled “The Modern Miracle of Israel” March 21-29, 2009, “The Tour,” the undersigned does hereby agree to the following:
The undersigned shall be liable for payment of all travel expenses in connection with his/her participation in the program as advertised, and within the outlined timeline.
The undersigned understands and herewith agrees that any expenses for services not specifically outlined in the tour description attached hereto constitute the sole responsibility of the traveler.
The undersigned agrees to accept the supervision and authority of the Director of the Program (‘Director’) or his/her designee; to comply with all the rules and regulations pertaining to travel, including but not limited to, customs and security guideline(s), airline regulation(s), as well as abiding by all laws of states or cities in which the undersigned may travel while a participant in the program.
In the event that the undersigned’s participation in the Tour is terminated voluntarily or involuntarily prior to the end of the Tour for which the undersigned is enrolled, the undersigned shall not be entitled to any refunds of Tour costs, fees, room and board, or travel expenses (unless the undersigned is eligible to receive a refund from a third party, i.e. insurance coverage, in connection with such costs and expenses). In no event shall the Travel and Learn, Inc. be liable or responsible for any such refund.
The undersigned hereby agrees and understands that Travel and Learn, Inc. their agents, employees, and all other persons acting on their behalf are hereby released from any and all liability of every nature,
kind and description as a result of any injuries, hurt, loss or damage sustained by the undersigned.
The undersigned agrees to indemnify and defend and hold harmless Travel and Learn, Inc. their agents, employees and all other persons acting on their behalf from any loss or claim of any kind whatsoever arising out of or relating to or in connection with the undersigned’s participation in the Tour.
The undersigned agrees that the foregoing terms are contractual and further states that he/she has carefully read the entire agreement and understands the contents thereof and signs the same as his/her own free acts.
2. CANCELLATIONS AND REFUNDS
All participants have the option to purchase trip cancellation insurance. The cost of the policy is due at the same time when the deposit is due. Information about the cancellation insurance provider and benefits is attached.
Cancellations must be made in writing (email communication is acceptable) to Travel and Learn, Inc.
Claims for refunds must be directed to the cancellation insurance underwriter indicated in the information attached.
3. CHANGES TO THE RESERVATIONS AFTER TICKETING
The undersigned understands and agrees that any changes in the reservations made in conjunction with this tour must be made in writing (email communication acceptable) no later than 7 business days after the deposit date of November 2, i.e. no later than November 11, 2008 at no charge.
Changes requested after November 11 will be assessed a change fee determined entirely by the airline. The undersigned understands and agrees that should a change in the itinerary be requested after November 11, such a fee will be assessed and will become due immediately to Travel and Learn, Inc.
Travel and Learn Inc. cannot guarantee that requests for changes or deviations from the attached itinerary can be fulfilled as requested.
TRIP CANCELLATION INSURANCE INFORMATION
Provider: CSA Travel Protection
P O Box 939057
San Diego, CA 92193
http://www.csatravelprotection.com
Ph: 800-873-9855
Plan: Freestyle
Benefits (maximum per policy):
Trip Cancellation: 100% of the cost (please review the situations covered)
Trip Interruption: 150% of the cost (please review the situations covered)
Trip Delay: $ 150.00 per day
Missed Connection: $ 2,000.00
Baggage and Personal Effects: $ 4,000.00
Baggage Delay: $ 800.00
Accident and Sickness Medical: $ 50,000.00
(Dental Expense Limit $750.00)
Emergency Assistance: $250,000.00
Air Flight Accident: $200,000.00
24hr Emergency Assistance
Identity Theft Resolution Services
Concierge Services
Pre-Existing Conditions
For more detailed information please review the information included in the link below:
http://www.csatravelprotection.com/certpolicysubmit.do
