EmailMe Form - Cloud 9 Getaways Travel Insurance Agreement

Cloud 9 Getaways Travel Insurance Agreement

I have read the travel insurance documents given to me by Cloud 9 Getaways and understand that travel insurance will protect my investment. I also understand that in the case of trip cancellation the cost of the insurance is non-refundable.

*If any travelers have Pre-Exisiting Medical Conditions the TravelSafe Gold or Platinum plan must be purchased within 14 days of booking your trip to be covered, and the Apple Vacations AV-OK plan must be purchased within 7 days of booking your trip to be covered. TravelSafe Silver Plan or Insurance purchased after 14 days will not cover instances due to Pre-Exisiting Medical Conditions.

I've decided to: *
PURCHASE travel insurance as offered by Cloud 9 Getaways
DECLINE travel insurance as offered by Cloud 9 Getaways
Plan:
Silver - TravelSafe
Gold - TravelSafe
Platinum - TravelSafe
AV-OK - Apple Vacations
If you are purchasing Trip Insurance please indicate which plan.
Primary Traveler Full Name: *
Prefix First Middle Last Suffix
Address of Primary Traveler *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Names of additional Travelers in group:
(Address if different from Primary Traveler) *
Email address: *
I understand that I must purchase Vacation Protection Insurance immediately to obtain maximum coverage. (Initials in box) *
(Initials in box)
I have been advised of the cancellation penalties for my purchase and I agree and understand that if I do not purchase Vacation Protection Insurance and subsequently cancel my purchase, I may forfeit all money deposited at the time of cancellation. (Initials in box) *
(Initials in box)
I understand that Vacation Protection Insurance can protect me from possible loss of money due to supplier bankruptcy/default, unexpected trip cancellation/interruption due to accident, sickness or death, baggage loss, medical expenses, and emergency air transportation costs. (Initials in box) *
(Initials in box)
By submitting this form I understand that I have released Cloud 9 Getaways from any and all liability regarding the purchase or non-purchase of travel insurance. (Initials in box) *
(Initials in box)
Digital Signature: *
First Last
Today's Date: *
MM / DD / YYYY

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