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Zenbiz Travel - Zenbiz Travel,KHM INSURANCE WAIVER
IMPORTANT INFORMATION REGARDING TRAVEL PROTECTION
Name
First
Last
Email
Phone
###
-
###
-
####
Today's Date
MM
/
DD
/
YYYY
VACATION INSURANCE
Booking #
If you cannot locate your confirmation #, please request one from us before submitting this form.
What type of Travel Protection Coverage are requesting?
Flight
Cruise
Land Package
Hotel
Rental Car
Cruise Package w/air/transfers/hotel
NONE - I waive Travel Protection
I waive Travel Protection and take full responsibility for anything that happens before or during the trip in additional to any medical or cancellation fees that may result from this trip.
Vacation Departure Date
MM
/
DD
/
YYYY
At this time I choose:
To purchase the recommended insurance
To decline the recommend insurance
Undetermined
You are advised that pre-existing conditions are only covered if Travel Protection is purchased within 14 days of the initial deposit.
Signature
Clear
