Insurance Waiver

IMPORTANT INFORMATION REGARDING TRAVEL INSURANCE

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Client's Name

Date of Departure

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PLEASE READ THIS CAREFULLY

Now that you have arranged your trip, as professional travel agents we feel that it is our

responsibility to recommend travel insurance to protect your investment. Please read the

attached TravelSafe brochure carefully in order to make an informed decision concerning this important matter. Ask us or call us with any questions you may have.

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AT THE TIME OF FIRST PAYMENT:

I have been advised of the cancellation penalties for my purchase. I acknowledge receipt of the TravelSafe brochure.
I understand that TravelSafe Insurance can protect me from possible loss of money due to supplier bankruptcy/default, unexpected trip cancellation/interruption due to accident, sickness or death, baggage loss, medical expenses, and emergency air transportation costs.
I understand that I must purchase TravelSafe Insurance immediately to obtain maximum coverage.

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AT THIS TIME, I CHOOSE: (CHOOSE ONE)

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To purchase the recommended insurance, I have mailed my completed TravelSafe application to TravelSafe.

To decline the recommended insurance.

To think about my decision.

New Field:

Date