ETI Travel Insurance Waiver Form

Travel Insurance Waiver

European Travel International, Inc., Mount Joy, PA
I have been offered and advised of travel protection/trip insurance options and fees by my Travel Consultant. I choose to decline travel protection/trip insurance.
Name

First NameLast Name
Insurance Provider offered:
*Example: Carnival Vacation Protection, Aliianz, AIG, etc
Do you already have insurance you purchased separately?*
Departure Date:

MonthDayYear
Date
Return date:

MonthDayYear
Date
Travel Supplier:
I decline the offer to purchase travel protection/trip insurance.

I understand that I am solely responsible for any penalties and out-of-pocket expenses incurred should I cancel or make changes to my travel plans.

I understand that I will be responsible for any medical expenses incurred in the case of an emergency while traveling.

I understand that I alone will be responsible for any and all changes to my current itinerary (including but not limited to air, rail and accommodation) in the event of an emergency while I am traveling.

I understand that I am not protected from loss in the event of any travel vendor/supplier/operator default. This waiver confirms that I voluntarily decline travel insurance and travel protection insurance for the trip plans described above. I understand I am solely liable for all airline fees, supplier fees, and agency fees that may apply, and I hereby release European Travel International from any and all liability related to the trip plans described above.
List of Travelers that also decline Travel Insurance*
I have read this document. I understand this document and all consequences resulting from my decision to decline travel protection/trip insurance.

I am signing for myself and on behalf of all travelers declining travel protection/trip insurance on the list above.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: