TRAVEL REGISTRATION FORM


departing 09/04/2012

04/20/2014 07:26:50 PM

YOUR DETAILS
Legal Name: (As it appears on passport)First: Middle: Last:
Title: (Mr/Mrs/Ms/Dr/Rev, etc.)
(Click Here for more information about passport books and passport cards)
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 NTS?:
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.)
(Click Here for more information about passport books and passport cards)
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 NTS?:
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 NTS (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:
Domestic Departure City:

SUMMARY SECTION (per person)
Basic Tour:
$0
Including tip charge under Itinerary Section
Single Room Basic:
$0
Domestic Departure City:
$0
Taxes and Fees:
$0
Administration Fee:
$0
Miscellaneous Charges:
$0

Online Registration Discount:
$0
Early Registration Discount:
$@ERRO
Not availble to Host/Co-Hosts
Tour Cost Per Person:
$@ERRO
Travel Protection Plan:
$0
Total Cost Per Person:
$@ERRO
Total People Registering:
x 1
.Passenger(s)
Total Cost this Registration:
$@ERRO

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: Noseworthy Travel Services,
P.O. Box 6378, Lakeland, FL 33807

Credit Card: Please note that Credit Cards will be charged by Educational Opportunities Tours, Inc.
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: Postal/Zip: -
Billing Country:

STATEMENT OF RESPONSIBILITY AND AGREEMENT
Enrollment in and payment of deposit constitutes your acceptance of the "Fine Print". Noseworthy Travel Services is the tour operator and is soley responsible for the travel program. Noseworthy Travel Services is registered with the State of Florida as a Seller of Travel. Registration No. ST24130. CST2027682-40
NTS 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.
NTS reserves the right to refuse or revoke travel to anyone who is, in the sole judgment of NTS, incapable of group travel without causing undue demands upon the staff or other tour participants. Except where otherwise stated, NTS acts only as an agent for the relevant supplier in securing hotels, transportation, and other travel services and in no event shall NTS 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 NTS 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. NTS does not own or operate any of the suppliers of services to your tour. Similarly, without limiting the foregoing, passenger agrees to hold NTS 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.
NTS 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 NTS and the right is reserved to cancel any tour prior to departure. NTS 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 NTS that all disputes and matters whatsoever arising under, or in connection with or incident to the responsibilities of NTS 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. CST 2027682-40
In the event that you cancel from this tour, cancellation penalties will apply as outlined in the tour brochure.
Except where otherwise stated, NTS acts only as agent for the relevant supplier in securing hotels, transportation and other travel services and in no event shall NTS be liable for failure by any such supplier to render any transportation, lodging or other travel service to be provided on the tour. NTS 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. NTS does not own or operate any of the suppliers of services to your tour. Similarly without limiting the foregoing, passenger agrees to hold NTS 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. Florida law will be applicable to any dispute which arises out of/or concerns this brochure or your tour.
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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