Spiekermann Travel - Reservation Form

Tour Reservation & Booking Form
Please complete, sign, date & return along with a clean colored copy of your passport’s 1st page (the one that you intend to use for this specific trip)
Trip Name and Date:*
(Tour name and date)
Extension to (If any):
(Name of the extension and indicate if it pre or post the main tour)
Traveler #1 Last Name:*
First Name:*
(Name exactly as they appear on passport)
Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone # (Home):

Area CodePhone Number
(Work):

Area CodePhone Number
(Cell):

Area CodePhone Number
Fax:
Email:
example@example.com
Passport #:
(Must be valid for at least 6 month from trip date)
Date of Issue:

MonthDayYear
Date
Place of Issue:
Citizenship:*
Upload a clean copy of your passport:

Browse Files

Cancelof
Marital Status:
Occupation:*
(If retired, previous occupation and company name)
Date of Birth:*

MonthDayYear
Date
Place of birth:*
Are you Vaccinated against COVID-19 (Required by some countries)

YesNo

Traveler #2 Last Name:
First Name:
(Name exactly as they appear on passport)
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (Home):

Area CodePhone Number
Work:

Area CodePhone Number
Cell:

Area CodePhone Number
Fax:
E-mail:
example@example.com
Passport #:
(Must be valid for at least 6 month from trip date)
Date of Issue:

MonthDayYear
Date
Place of Issue:
Citizenship:
Upload a clean copy of your passport:

Browse Files

Cancelof
Marital Status:
Occupation:
(If retired, previous occupation and company name)
Date of Birth:

MonthDayYear
Date
Place of Birth:
Father's First Name:
(This is required for some visa applications)
How did you hear about us:
Person to be notified in case of Emergency
Name & Relationship:*
Phone #:*

Area CodePhone Number
Describe any Health Problems:
Food/Dietary Restrictions:
By signing for this trip, I admit and confirm my full understanding of the nature of the tour and the physical requirements to be able to keep up with the pace of the visits and the sightseeing and that I am not in any way going to cause delays to the tour group or its other fellow members and if I cause so, I could be denied participation in the tour.
Accomodation
Would like to share room:

Yes, Please try to assign me a roommateYes, I will share accommodations with
(Name)
No
Single accommodations may be available at an additional cost. Single travelers for whom roommates are not available are subject to single supplement charges.

Air Booking
I will do my own international air:
I want STS to help me book my ticket (Extra Cost as the International air is not included in the tour):

Please contact our office for the air reservation assistance.
Notes:
* Depending on airline policy, air ticket may be unchangeable/nonrefundable after issue)
* Seat assignment are based on availability at the time of check-in, additionally, airlines maintain complex rules regarding fare classifications that can affect mileage accrual. STS is NOT responsible for any discrepancies or issues that arise from these airline policies. Please ensure you understand the rules specific to your fare to avoid any inconvenience during your travel.
Payment
A deposit of $750.00 per person is required to process your reservation, unless otherwise specified in a specific tour brochure. The remaining balance is typically due 60 days prior to departure unless noted differently. Please ensure that all payments are made by the specific deadline to secure your travel arrangements.
Pay online by credit card (Click the link below to pay):
https://www.clover.com/pay-widgets/b02588e0-2371-4fd7-bd17-40776d04274f
Pay online through our Secure Portal (same as check- Click the link below to pay): https://ww2.payerexpress.com/ebp/SpiekermannT/
Check enclosed by regular mail
Deposit in the amount of: (if different than $750) for this tour
Charge my Credit Card:
Credit Ccard #
Exp. dateCVV
 I would like to authorize STS to charge further payments and balance of my trip on the same credit card depicted above, when the due date comes up or to issue my air ticket without any further notifications from me.
Signature for credit card charge:

Clear
Signature for credit card charge:

I would like to authorize STS to charge further payments and balance of my trip on the same credit card depicted above, when the due date comes up
Signature

Clear

Loyalty Club:
Discount apply only to scheduled group departure tours and NOT customized or private tours ot extensions, nor for booking made through 3rd party travel agencies. Discounts are 2% for those who took 1-4 prior tours, 3% for 5-9 tours and 5%for 10 or more tours.
Trip Name / Year
Trip Name / Year
Trip Name / Year
Trip Name / Year
Trip Name / Year
Trip Name / Year
Trip Name / Year
Trip Name / Year
Trip Name / Year
Trip Name / Year
Release of Liability:
STS acts only as an agent for the passenger concerning transportation, hotels, cruise and all matters of reservations and operation of the tour. STS and its agents and representatives do not accept responsibility for loss, damage, injury, accident, delay, irregularity, expense, or liability caused by negligence or default of any of their subcontracting organizations, their employees, their agents or representatives, including consulates, passport agencies, mail couriers or border & airport security conditions. Any such losses or expenses shall be solely the responsibility of the participant. We reserve the right to cancel the tour prior to departure in which case the full payment of the “land portion” will be refunded to the participant without further obligations on our part. It is understood that air tickets are issued, they shall serve as the sole contract between the passenger and the airline concerned. STS or any of their subcontractors in various countries are not liable for any act, omission, unforeseen change, or events that may affect the passenger(s) while traveling to/from the destination. Furthermore, STS its agents and representatives, and the airlines involved are not responsible of any sickness, injury, accidents, dismemberment, terrorist attacks, complica¬tions from civil unrest or disturbance in the political climate at the destination or relations between the USA and the visited country including in the event of the passenger’s death.

By signing up for this trip, I acknowledge that I have been informed about the option to purchase individual travel protection insurance. I am fully aware that the destination(s) may currently have a travel warning issued by the US State Department (www.travel.state.gov). it is with my complete free will that ii choose to join this specific tour. I understand that airlines inherent hazards and risks. I acknowledge that unforeseen events which are completely beyond the control of Spiekermann Travel Services (STS) , may occur and could lead to cancelation of the tour or alterations to the proposed itinerary. I accept this risks, and the potential costs associated with them. I agree not hold STS liable for any damages or losses resulting from my participation in this tour.

As we plan your tour arrangements many months in advance, please be advised that changes or cancelations may occur due to lack of participation or Force Majeure circumstances. We reserve the right to modify ot cancel the tour at any time. while we rarely need to change tour leaders or airlines, we maintain the right to do so if deemed necessary. By booking your tour, you acknowledge that safety standards in the developing world-pertaining to vehicles, roads and tourist sites-may not align with those typically found in the US. If you any legitimate complaints regarding your tour arrangements, it is imperative to inform our relevant local supplier immediately. Should your complaint(s) remain unsolved, by our local representative, please reach out to our US office directly. contact our US office directly. Failure to follow this procedure may prevent us from investigating and rectifying your concerns in a timely manner, potentially impacting your rights regarding compensation under this contract.
Signature (I have read and accept this entire Release of Liability)*

Clear
Date

MonthDayYear
Date
Signature

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SIGNATURE (1)*

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Passports & Visas:
You must ensure that your is valid for 6 months from beyond the date of return to the US and must contain empty “Visa” pages. It is your responsibility to verify with the relevant consular offices of the country/ies being visited to determine if a visa is necessary. STS is not liable for any issues related to passport or visa, including delays or any unforeseen circumstances that may affect the trip. It is imperative that you provide STS with the valid passport intended for this trip you are registered for. Any amendments or changes to the passport after booking may hinder visa procurement and could incur additional expenses for resubmission of information. A fee of $50.00 will be added to the final invoice in the event of such passport modifications. Upon acceptance of a travel application, this agreement is considered to take effect in Eastpointe, Michigan and will be governed by Michigan law. In the rare occurrence that a legal dispute arises related to this agreement, it will be resolved through binding arbitration by the Ameri¬can Arbitration Association in Michigan. Should this arbitration clause be deemed unenforceable, any legal proceedings will be initiated in the appropriate court in Macomb County, Michigan, or in Federal Court in Michigan. Furthermore, if the plaintiff does not prevail in any legal action, they agree to cover all reasonable attorney fees for the defendant involved in the dispute.

With regard to credit card sales for services related to this tour, the client acknowledges and agrees to hold STS, its agents and representatives harmless for all chargebacks initiated by the client or their credit card companies. This includes chargebacks arising from complaints concerning unsatisfactory services, any failure to utilize portions of the prepaid tour, or any other reasons that may lead to such actions. The client understands that they are solely responsible for any disputes or claims related to chargebacks, and they waive the right to seek recovery from STS or its representatives for any associated damages or losses.

Cancellations & Refunds:
Cancellations must be received in writing and will be processed according to the date the written notice is received. Although a verbal cancellation is appreciated, it will not be accepted as final notice. Departure is defined as the date of the first flight from the US, or the trip departure date as indicated on our Tour Schedule, whichever comes first. Please ensure that your written cancelation includes your booking details to facilitate processing.

1. Money will be refunded minus the following cancellation fees/penalties per person (unless different for a particular trip, then the special cancellation schedule of that trip will apply):

From time of booking up to 120 days prior to departure $250.00 per person
From 119 days to 90 days prior to departure $500.00 per person
From 89 days to 60 days prior to departure $750.00 per person
From 59 days to 30 days prior to departure 75% of the total land cost
From 29 days to prior to departure No refund

2. In addition to the aforementioned penalties, any extra charges related to airline tickets imposed by the airlines for cancelations or date changes after the ticket has been issued will be fully borne by the traveler. Furthermore, all expenses incurred in obtaining visas will also be the sole responsibility of the traveler and are non-refundable by STS or its suppliers. It is important for travelers to understand that these costs are separate from any service fees or penalties outlined in the booking agreement.

3. Hotel rooms booked on our tours are run by The House (ROH), that means that specific room assignments, such as those with views or located on upper floors, are not guaranteed. If clients wish to secure these special room types, they will incur an additional supplement, which is their responsibility to cover. We recommend discussing any room preferences with our team at the time of booking to explore available options and potential cost.

 I have read & accept this entire Release of Responsibility and I have read and accept the complete Terms & Conditions of the tour I am booking, including notification of cancellation penalties. I fully understand all contents of this document and agree with the same. By making this booking with STS you guarantee that you have the authority to accept & do accept on behalf of your party the terms of these booking conditions.
Date

MonthDayYear
Date
Terms and Conditions
SIGNATURE (2)

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Date

MonthDayYear
Date
Spiekermann Travel Service, Inc., 18421 E. Nine Mile Rd., Eastpointe, MI 48021
Fax: 586-775-9556 Ph: 586-775-9550 email: info@mideasttrvl.com
Toll Free: 800-645-3233 URL: www.mideasttrvl.com
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