EHTravels GIT/Escorted Tour Booking Form

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

MonthDayYear
Tour Type
Group Leader's Name

First NameLast Name
Check if you require special assistance while traveling
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 NameMiddle NameLast Name
Sex
Date of Birth

MonthDayYear
Is the traveler a minor?
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)

MonthDayYear
If not a US Citizen, is the traveler a legal resident alien?
Traveler Address and Contacts
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number
E-mail
Emergency Contact
Name

First NameMiddle NameLast Name
Relationship to Traveler
Sex
Check if address is the same as above
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone 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)
Payment Information
How would you like to pay?
Method of payment
Name on the Card

First NameLast Name
Credit Card Type
CCInfo
FOR SECURITY THIS INFORMATION IS COLLECTED BY PHONE
Billing Zip Code
Amount at the time of booking

prevnext( X )
USDBooking Payment Amount
Travel Insurance Coverage
Would you like to add Travel Insurance Protection (NOT-REFUNDBLE)?
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

MonthDayYear
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EHTravels GIT/Escorted Tour Booking Form

TSA Traveler Information

Traveler Address and Contacts

Emergency Contact

Payment Information

Amount at the time of booking*

Travel Insurance Coverage

Signature and Agreement

Amount at the time of booking