TRAVEL REGISTRATION FORM



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04/23/2014 04:30:38 AM
YOUR DETAILS
Legal Name: (As it appears on passport)First: Middle: Last:
Title: (Mr/Mrs/Ms/Dr/Rev, etc.)
Preferred First Name: (If different than First Name listed above. Leave blank if First Name listed above is your Preferred Name)
Street Address:
P.O. Box:
City:
State/Province, Postal Code:State/Province: Zip/Postal:
Country:
Home Phone: (with area code)
Work Phone: (with area code)
Email Address:
Birth Date: (Required by the airlines)Month: Day: 4 digit Year:
Sex:
Nationality:
First trip with EOT?
Emergency Contact:
Phone:
(with area code)
Relationship:
COMPLETE THIS SECTION IF YOUR SPOUSE OR CHILD IS TRAVELING WITH YOU
Legal Name: (As it appears on passport)First: Middle: Last:
Title: (Mr/Mrs/Ms/Dr/Rev, etc.)
Preferred Name: (If different than First Name listed above. Leave blank if First Name listed above is your Preferred Name)
Birth Date: (Required by the airlines)Month: Day: 4 digit Year:
Sex:
Nationality:
First trip with EOT?
Emergency Contact:
Phone:
(with area code)
Relationship:
SMOKING, ROOMMATE AND TRAVEL PROTECTION PLAN
Smoking Preference:
Roommate:
Roommate Name: (only if not listed in section above)
Travel Protection Plan:
Click Here to review Travel Protection Plan coverage and benefit details.Important Information regarding the Travel Protection Program: (1) Coverage cannot be added after you have paid in full. (2) Premium is based on TOTAL cost of trip and is non-refundable. (3) Coverage begins when your premium payment is received by EOT (made separately from deposit & clearly designated as your Travel Protection Plan premium). (4) Coverage is not available for those living outside of the United States of America or Canada.
ITINERARY SELECTION
Register Me/Us For:
Pre-Tour:
Post-Tour:
Domestic Departure City:
Special requests may be made once you have received your statement from us. ID numbers on your statement will allow you to access "My Account" on line where special requests are submitted.
SUMMARY SECTION (per person)
Basic Tour:
$0
Including tip charge under Itinerary Section
Single Room Basic:
$0
Pre-Tour:
$0
Including tip charge under Itinerary Section
Single Room Pre-Tour:
$0
Post-Tour:
$0
Including tip charge under Itinerary Section
Single Room Post-Tour:
$0
Domestic Departure City:
$0
Taxes and Fees:
$0
Administration Fee:
$0
Miscellaneous Charges:
$0
Early Registration Discount:
$@ERRO
Not availble to Host/Co-Hosts
Tour Cost Per Person:
$@ERRO
Travel Protection Plan:
$@ERRO
Total Cost Per Person:
$@ERRO
Total People Registering:
x 1
.Passenger(s)
Total Cost this Registration:
$@ERRO
Promotional Code:
Promotional discounts will be deducted from the Total Cost listed above once eligibility has been verified. Your Total Cost will be reflected on your Invoice that will be mailed once payment has been processed.
PAYMENT INFORMATION
A Deposit of $@ERRO Per Person ($@ERROR.00 Total) must be remitted in order to process this Travel Registration.
Form of Payment:
NOTE: If you are paying by CHECK, your deposit payment must be received in our office within 10 business days to avoid cancellation.

If Paying by Check, Please
Enter Your Check Number:

Make check payable to: Educational Opportunities Tours,
P.O. Box 6098, Lakeland, FL 33807

Credit Card:
Credit Card Number: (No spaces or dashes)
Credit Card Verification Number: Help
Expiration Date: /
Name as it appears on Card:First Name:
Last Name:
Billing Address:
Billing City:
Billing State/Province, Postal Code:State/Province: Zip/Postal: -
Billing Country:
STATEMENT OF RESPONSIBILITY AND AGREEMENT
Enrollment in and payment of deposit constitutes your acceptance of the "Fine Print". Educational Opportunities Tours is the tour operator and is soley responsible for the travel program. Educational Opportunities Tours is registered with the State of Florida as a Seller of Travel. Registration No. ST24130. CST2027682-40
EOT agrees to provide the itinerary described in this brochure, no changes or deviations to the itinerary are effective unless approved in writing and signed by an authorized officer of the tour operator. Except as stated herein, no person is authorized to cancel, modify or vary the tour arrangements or to make any representation of warranty concerning the tour.
EOT reserves the right to refuse or revoke travel to anyone who is, in the sole judgment of EOT, incapable of group travel without causing undue demands upon the staff or other tour participants. Except where otherwise stated, EOT acts only as an agent for the relevant supplier in securing hotels, transportation, and other travel services and in no event shall EOT be liable for failure by any such supplier to render any transportation, lodging or other travel service to be provided on the tour.
The passenger agrees that EOT assumes no liability for injury, death, damage, loss, accident, delay or irregularity which may occur by reason of any negligent or willful act or omission of any suppliers of service. EOT does not own or operate any of the suppliers of services to your tour. Similarly, without limiting the foregoing, passenger agrees to hold EOT harmless for any defect in any vehicle, plane, boat, bus, car, van or other vehicle, act of war or insurrection, terrorist activity, revolt or other civil uprising, military action, strikes or labor unrest or any Act of God or for any other act of any third party.
EOT does not accept responsibility for losses or additional expenses due to delay or changes in air schedules, hotel overbookings or other hotel related problems or other causes. All such losses or expenses will be the responsibility of the passenger. The right is reserved to make adjustments to the itinerary as deemed desirable to EOT and the right is reserved to cancel any tour prior to departure. EOT may not be held responsible for any loss or damage to luggage during the tour program. Enrollment in, payment of deposit and/or acceptance of final documents, vouchers, or tickets shall be deemed to be consent to the Program Conditions and Statement of Responsibility. Prices are based on tariffs in effect as of January 1 of the previous year and are subject to adjustment without notice in the event of any change or currency fluctuation.
It is agreed by and between the passenger and EOT that all disputes and matters whatsoever arising under, or in connection with or incident to the responsibilities of EOT shall be litigated in and before a court located in the State of Florida, USA to the exclusion of the courts of any other state or country. Florida law will be applicable to any dispute which arises out of/or concerns this brochure or your tour.
In the event that you cancel from this tour, cancellation penalties will apply as outlined in the tour brochure.
You must be at least 18 years of age to accept this Agreement and Statement of Responsibility




All amounts listed are in U.S. Dollars

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