|
American Heritage Student Tour Application
School:______________________________________
Passenger Name_________________________Student____Adult______
Parents Name ______________________________
Home
Address_________________________________________________
City______________________________Zip Code
___________________
Home Phone____________ Work Phone _______________ Cell Phone____________
Person to contact in
emergency:___________________________________________________________
Home Phone_____________________Work
Phone__________________Cell
Phone________________
Relationship___________________________________________________________________________
Cancellations after
final payment due date are non-refundable. Failure to pay final payment by due
date will result in cancellation and forfeiture of deposit unless arrangements
are made in advance.
Trip cancellation insurance is available and highly
recommended.
RESPONSIBILITY
Slotsy Tours and Travel, Inc., Fullerton,
CA acts only as an agent for the various
transportation, hotel, sightseeing and/or service companies used, all of whom
are disclosed principals. Slotsy Tours and Travel, Inc. can not be held
responsible for loss, damage, or injury occasioned by neglect, default, or
failure of any companies or persons engaged in conveying the tour other than
those persons employed by Slotsy Tours and Travel, Inc. Slotsy Tours and
Travel, Inc. can accept no responsibility for losses or additional expenses due
to delay or change in transportation or other services, sickness, weather,
strike, war, or other causes. Slotsy Tours
and Travel, Inc. reserves the right to accept, decline, or to retain any person
as a member of this tour at any time. There is no refund for unused services.
The right is reserved to alter this program to accommodate unforeseen
developments. I understand that the pricing and operation of this tour program
is dependent upon a minimum number of participants.
______________________________________
______________________________________
Signature, Tour Member
Signature, Legal Guardian
Date:__________________________________
Slotsy
Tours and Travel, Inc. Eastside Christian School
CST#1007912-10
LIABILITY
RELEASE / MEDICAL RELEASE
I am aware that my son/daughter has made a
reservation for, and is going on, a tour arranged by Slotsy Tours and Travel,
Inc. I am further aware that arrangements made by Slotsy Tours and Travel, Inc.
(hereafter referred to as "agent") include air transportation,
motorcoach touring, hotel accommodations and admission to attractions
specifically listed in the trip itinerary.
It is my understanding that Slotsy Tours and
Travel, Inc. is acting only as an agent for the various transportation, hotel,
and sightseeing and/or other service providers. I agree that any activity on
the part of my son/daughter that would be hazardous or detrimental to him/her
or any other person, or to the group as a whole, will be grounds for his/her
return to the city of departure by the most convenient method of transportation
available at my full expense. I agree that if the agent expends any monies to
return my son/daughter to the city of departure because of his/her behavior,
accident or illness, I will immediately reimburse the agent for said
expenditures. I agree that I am also responsible for any damages caused to
private property by my son/daughter during this trip.
In consideration of granting my child
permission to travel with the agent, on behalf of myself and the minor, I
hereby waive all rights to claim damages against, and release from all
liability, the personnel and officials of the agent. I hereby assume all risks
that might be inherent in this activity.
Slotsy Tours and Travel, Inc. acts only as
an agent for the various transportation, hotel, sightseeing and/or other
service companies used, all of whom are disclosed principles. It cannot be held
responsible for loss, damage, or injury occasioned by neglect, default, or
failure of any companies or persons engaged in conveying the group. Agent can
accept no responsibility for losses or additional expenses due to delay or
change in transportation or other services, sickness, weather, strike, war, or
other causes. Agent reserves the right to accept, decline, or to retain any
person as a member of this group at any time. The right to alter this
program is also reserved. I understand that should my son/daughter violate
the instructions of the tour escort, that he.she will be flown home on the first
available flight at my pre-paid expense.
I (we) hereby authorize a representative of
Slotsy Tours and Travel, Inc. to obtain medical or surgical care for my child
as needed, and that I (we) accept responsibility for the cost of said
treatment.
Signed and
agreed to this ___________day of ___________, 2007.
____________________________________________ ___________________________________
Parent Signature OR Legal
Guardian Signature
Student /Adult Name(Print
Clearly):___________________________________
Please list any
medications or chronic conditions:
______________________________________________________________________________________
______________________________________________________________________________________
Health Insurance
Carrier:__________________________________________________________________
Member/Policy
Number__________________________________________________________________
(Covered Family
Member's Name)__________________________________________________________
Parent Statement of
Responsibility and Liability Release
(Keep for your files)
LIABILITY
RELEASE / MEDICAL RELEASE
I am aware that my son/daughter has made a
reservation for, and is going on, a tour arranged by Slotsy Tours and Travel, Inc.
I am further aware that arrangements made by Slotsy Tours and Travel, Inc.
(hereafter referred to as "agent") include air transportation,
motorcoach touring, hotel accommodations and admission to attractions
specifically listed in the trip itinerary.
It is my understanding that Slotsy Tours and
Travel, Inc. is acting only as an agent for the various transportation, hotel,
and sightseeing and/or other service providers. I agree that any activity on
the part of my son/daughter that would be hazardous or detrimental to him/her
or any other person, or to the group as a whole, will be grounds for his/her
return to the city of departure by the most convenient method of transportation
available at my full expense. I agree that if the agent expends any monies to
return my son/daughter to the city of departure because of his/her behavior,
accident or illness, I will immediately reimburse the agent for said
expenditures. I agree that I am also responsible for any damages caused to
private property by my son/daughter during this trip.
In consideration of granting my child
permission to travel with the agent, on behalf of myself and the minor, I
hereby waive all rights to claim damages against, and release from all
liability, the personnel and officials of the agent. I hereby assume all risks
that might be inherent in this activity.
Slotsy Tours and Travel, Inc. acts only as
an agent for the various transportation, hotel, sightseeing and/or other
service companies used, all of whom are disclosed principles. It cannot be held
responsible for loss, damage, or injury occasioned by neglect, default, or
failure of any companies or persons engaged in conveying the group. Agent can
accept no responsibility for losses or additional expenses due to delay or
change in transportation or other services, sickness, weather, strike, war, or
other causes. Agent reserves the right to accept, decline, or to retain any
person as a member of this group at any time. The right to alter this
program is also reserved. I understand that should my son/daughter violate
the instructions of the tour escort, that he.she will be flown home on the
first available flight at my pre-paid expense.
I (we) hereby authorize a representative of
Slotsy Tours and Travel, Inc. to obtain medical or surgical care for my child
as needed, and that I (we) accept responsibility for the cost of said
treatment.
Signed and
agreed to this ___________day of ___________, 2007.
___________________________________
Parent Signature OR Legal
Guardian Signature
Student /
Passenger Name (Print Clearly):___________________________________
Operator: Slotsy Tours and
Travel, Inc, 515 W. Commonwealth Ave. Suite 103, Fullerton, CA 92832
(800)336-2844 CST#1007912-10
|
