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• Travel Insurance Waiver Form

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• Booking Confirmation Number*
• Last Name, First Name
• Email
• Phone

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• I have been advised of and offered Travel Insurance/Trip Protection options by my travel agent.*

  Yes
  No
  
• I choose to waive Travel Insurance for this trip.*

  Yes
  No
  
• Reason for Waiving Coverage* Select Already Have Coverage Cost of Use Do Not Want Ease of Use
• If already covered, please provider insurer, policy number, insurer phone and address.*
• List all travelers included under this booking confirmation.

  Name	Email	Phone

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