RESERVATION REQUEST Return to: Cruise & Tour * PO Box 398 * Waterford * WI * 53185 Phone: (262) 534-‐7300 * Fax: (262) 514-‐2308 * Email: info@cruise-‐tour.com
TRIP DATES: October 23rd – 27th , 2016 GROUP: Karen Ellenbecker’s Mystery Tour PASSENGER INFORMATION FIRST NAME MIDDLE NAME
LAST NAME 1. 2. Badge Name #1: Street Address: City: Home Phone: Main Email:
DATE OF BIRTH
1.
2.
Badge Name #2:
State:
Zip: Main Cell Phone: Secondary Email:
RESERVATION DETAILS DEPARTURE: ( ) Home pick up at above address ( ) Local area pickup HOTEL REQUEST: (Request only – not guaranteed): ( ) 1 king/queen bed ( ) 2 double/twin beds Rooms are Non Smoking GROUP ROSTER: May we include your name and address on a list to be given to all participants: ( ) Yes ( )No TSA Pre-‐check #1:___________________________________________ #2__________________________________________________ TRAVEL INSURANCE CHOOSE AND INITIAL “A” OR “B” (Reservation will be returned if “A” or “B” is not initialed.) CHOICE “A” INITIAL HERE _____ -‐-‐ I have received information on RoamRight Insurance and am applying for coverage today in order to have the Pre-‐Existing Medical Condition Exclusion waived for myself, my traveling companion(s), and for any other family member whose health status may affect my ability to travel. My completed application is enclosed. (Return to Cruise & Tour with this form.) CHOICE “B” INITIAL HERE _____ -‐-‐ I have received information on RoamRight and choose NOT to apply for this coverage. I understand this is a one-‐time opportunity to have the Pre-‐Existing Medical Condition Exclusion waived, and I hereby assume all pre-‐ and post-‐departure risks otherwise covered by this policy.
DEPOSITS & RESERVATIONS A $750 per person deposit is required with your Reservation Request. Final payment is due 7/22/16. PLEASE BE ADVISED – DEPOSIT AND FINAL PAYMENT PAYABLE BY CASH OR CHECK ONLY. DEPOSIT ENCLOSED: ( ) Check in the amount of $________________payable to “Cruise & Tour” enclosed
PLEASE SEE OTHER SIDE FOR TERMS & CONDITIONS
IN THE EVENT OF AN EMERGENCY, WHO WOULD YOU LIKE US TO CONTACT Name: Relationship: Home Phone: ( ) Cell Phone: ( ) Please list any health concerns: HOW DID YOU HEAR ABOUT US? Is this your first time traveling with Cruise & Tour? __________YES __________NO If you, did a Cruise & Tour client refer you to us? If so, please print their name here so we can reward them. _____________________________________________________________________________________________________________________________ TERMS AND CONDITIONS RESERVATION REQUEST FORM: A completed and signed form is required for a confirmed reservation. Please include an email address that you check often as almost all Karen Ellenbecker Mystery Tour information including booking confirmations, receipts, updates, offers, etc., will come to you via email. DEPOSITS AND PAYMENT: A $750 per person deposit is required with your Reservation Request. Final payment is due 7/22/16. PLEASE BE ADVISED -‐ YOUR DEPOSIT AND FINAL PAYMENT CAN BE MADE BY CASH OR CHECK ONLY. CANCELLATIONS AND REFUNDS: For cancellations received in writing prior to 5/23/16, your initial deposit payment stated above is refundable less a $250 administrative fee. For cancellations received in writing between 5/23/16 and 7/22/16, full deposit becomes non-‐ refundable. After 7/22/16 or non-‐appearance on departure day, 100% of the cost of your travel arrangements is forfeited. Any amount not refunded due to cancellation or non-‐appearance may be recovered from RoamRight Insurance, subject to purchase of coverage and the terms and limitations of the policy. MEDIA DISCLAIMER: Cruise & Tour uses photographs, videos, and testimonials in publications, public announcements, on it’s website and in social media outlets. By signing this form I hereby grant Cruise & Tour royalty-‐free permission to publish any video, photos, or testimonials in printed publications, media publications, on our website, and in Cruise & Tour-‐related social media outlets. The above mentioned will be used for informational and promotional purposes only. Under no circumstances will they be sold or distributed for sale. I acknowledge that inclusion in Cruise & Tour’s publications, social media outlets and web site is voluntary and no financial compensation will be received. I hereby agree to release and hold harmless, Cruise & Tour and it’s employees from and against any claims, damages or liability arising from or related to the use of the photographs, videos, or testimonials CONSUMER DISCLOSURE NOTICE: Downtown Travel, Inc. d/b/a Cruise & Tour is acting as intermediary and agent for suppliers in selling services, or in accepting reservations or bookings for services that are not directly supplied by this travel agency (such as air carriage, hotel accommodations, ground transportation, meals, tours, cruises, etc.). This agency, along with the Karen Ellenbecker Group, therefore, shall not be responsible for breach of contract or any intentional or careless actions or omissions on part of such suppliers, which result in any loss, damage, delay, or injury to you or your travel companions or group members. Unless the term “guaranteed” is specifically stated in writing on your tickets, invoice, or reservation itinerary, we do not guarantee any of such suppliers’ rates, bookings, or reservations. Cruise & Tour and the Karen Ellenbecker Group shall not be responsible for any injuries, damages, or losses caused to any traveler in connection with terrorist activities, social or labor unrest, mechanical or construction difficulties, diseases, local laws, climatic conditions, abnormal conditions or developments, or any other actions, omissions, or conditions outside their control. By embarking upon his or her travel, the traveler assumes all risks involved with such travel, whether expected or unexpected. Traveler is hereby warned of such risks, and is advised to obtain appropriate insurance coverage against them. Your retention of tickets, reservations, or bookings after issuance shall constitute a consent to the above, and an agreement on your part to convey the contents hereto your travel companions or group members. Cruise & Tour reserves the right to correct mathematical or other errors on the traveler’s reservation confirmation at any time prior to departure. Cruise & Tour reserves the right to refuse to accept or retain any person as a participant in this travel program at any time for any reason whatsoever. Minimum of 19 paid passengers required for Karen Ellenbecker to travel as host. In the event of unforeseen circumstances such as illness, family emergencies or acts of God and Karen Ellenbecker is not able to travel as host, there are no refunds or cancellation fee waivers due to passengers.
I understand and agree to the above, and I also acknowledge that I have no idea where I am going on this trip or what I will be doing, and whatever Karen Ellenbecker decides to plan will be fine with me and my traveling companion.
________________________________________________________________________________________________________________________________________ Signature of person paying deposit Today’s Date
Return to: Cruise & Tour * PO Box 398 * Waterford * WI * 53185 Phone: (262) 534-‐7300 * Fax: (262) 514-‐2308 * Email: info@cruise-‐tour.com
n to: CRUISE & TOUR, P.O. 398, Waterford, WI 531