EHTravels GIT/Escorted Tour Booking Form

EHTravels GIT/Escorted Tour Booking Form
Tour Name and Code *
Preferred Departure Date

Month Day Year Date Picker Icon
Tour Type

FIT Group
Group Leader's Name

First Name Last Name
Check if you require special assistance while traveling

Yes, I do require special assistance
TSA Traveler Information
Traveler's Name (To avoid name-change penalties of a minimum of $170, make sure your name reflects the spelling in your passport) *

First Name Middle Name Last Name
Sex *

Male Female
Date of Birth *

Month Day Year
Is the traveler a minor?

Yes, the traveler is under 18 YOA
TSA Redress Number (if applicable)
Country of Residence *
Citizenship *
Travel Document Type *
Travel Document Number
Expiration Date (Note: As per U.S. DHS requirements your passport must have at least 6 months of validity after the completion of your travel) *

Month Day Year Date Picker Icon
If not a US Citizen, is the traveler a legal resident alien?

Yes No
Traveler Address and Contacts

Home Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone Number

Area Code Phone Number
Cell Phone Number *

Area Code Phone Number
Work Phone Number

Area Code Phone Number
E-mail *
Emergency Contact
Name *

First Name Middle Name Last Name
Relationship to Traveler *
Sex *

Male Female
Check if address is the same as above

Yes

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone Number

Area Code Phone Number
Cell Phone Number *

Area Code Phone Number
Work Phone Number

Area Code Phone Number
Is Exploring Horizons allowed to release personal information (including, but not limited to, medical information) in case of an on-tour emergency? (for minors, full disclosure applies automatically) *

Yes, release my information
Payment Information
How would you like to pay? *

Pay in full Monthly Invoices
Method of payment *

Cash Check Credit Card (Fill out the CC info below. DO NOT write your CC Number)
Name on the Card

First Name Last Name
Credit Card Type

VISA MC AMEX DISC
CCInfo
FOR SECURITY THIS INFORMATION IS COLLECTED BY PHONE
Billing Zip Code
Amount at the time of booking *

USD Booking Payment Amount
Travel Insurance Coverage
Would you like to add Travel Insurance Protection (NOT-REFUNDBLE)? *

Yes, add Travel Insurance Protection to my tour No, thank you. I assume and understand that there is a risk involved with my travel and my travel activities and/or excursions. I acknowledge that I was informed about my options but I declined the insurance.
Signature and Agreement
Before signing this e-form please take a moment to read our Booking Terms & Conditions found here below.

By signing this form the participant and/or the parent/guardian acknowledges to have read, have fully understood, and have agreed to be bound by, and to comply with Exploring Horizons Ltd. Inc. General Conditions, Booking, Payment, On-the-Go Rules, Waiver, and Release, and Agreement Policies. By signing this form the signee authorizes Exploring Horizons Ltd. Inc. to charge the credit card listed herein for the amount shown and, if applicable, for all future payments related to this tour (automatic charge without any further reminders on due date) unless other payment arrangements have been stipulated.

Note: If participant is under 18 YOA, parent/guardian must sign.
Traveler Signature (use your mouse or finger to sign) *
Parent/Guardian Signature (use your mouse or finger to sign)
Date Signed *

Month Day Year Date Picker Icon
Enter the message as it's shown *
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

EHTravels GIT/Escorted Tour Booking Form

TSA Traveler Information

Traveler Address and Contacts

Emergency Contact

Payment Information

Travel Insurance Coverage

Signature and Agreement