Travel Insurance Waiver

Travel Insurance has been offered to client. Client declined to invest in travel insurance

Name*
First Last
Please enter your first and last name as it appears on your Government -issued ID or Passport.
Today's Date*
Date Format: MM slash DD slash YYYY

Please provide today's date.
Phone*
Please provide a valid current contact number.
Email Address*
Enter Email Confirm Email

Please provide a valid email address that belongs to you.
I Decline Travel Insurance*
Yes, I have been offered travel insurance by Bev's & Mac's Leisure Travels, and I am fully aware that travel insurance is HIGHLY RECOMMENDED; however, I respectfully decline at this time and will sign the waiver!
First Travel Date*
Date Format: MM slash DD slash YYYY

Please provide the first start of your travel date. This is the date you leave for vacation
Return Travel Date*
Date Format: MM slash DD slash YYYY

Please indicate the date you expect to return home from your vacation. This is the date your vacation ends.
Signature*
Please provide your signature as a confirmation that you decline the travel insurance!
Please Print Your First & Last Name*
Please provide your first and last name, legibly, as a secondary confirmation of the travel waiver.
What Type of Travel Components Are You Booked For?*
Please indicate the type of travel component(s) that you booked with Bev's & Mac's Leisure Travels
Comments
Please provide comments or concerns

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