Ruppert Travel, LLC
Travel and Insurance Disclaimer
Name
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First Name
Last Name
Email
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example@example.com
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
I understand that John Ruppert and Ruppert Travel, LLC (an agent with the host agency Cruises and Tours Unlimited) are not the source or supplier of the travel services I have requested and acts solely as an agent for the actual suppliers of such services. I have been advised that the suppliers whose names appear in the information supplied to me are those who are actually responsible for providing the travel services I have purchased.
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Yes - I Agree
I consent to and request the use of those suppliers and agree not to hold John Ruppert or Ruppert Travel, LLC responsible should any of these suppliers: 1) fail to provide the travel services I have purchased; 2) fail to comply with any applicable law; or 3) engage in any negligent act or omission that causes me any sort of injury, damage, delay or inconvenience.
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Yes - I Agree
I will review my travel documents for accuracy upon receipt and understand that I may contact Ruppert Travel, LLC if I have any questions. I understand that discounted fares typically involve restrictions and that changing any aspect of my travel arrangements may result in the payment of additional money. Conversely, cancellation of any aspect of my travel arrangements may result in financial penalties, in accordance with the supplier’s cancellation policies.
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Yes - I Agree
Privacy Notice (TSA Update: August 13, 2009): The Transportation Security Administration (TSA) requires you to provide your full name, date of birth, and gender for the purpose of watch list screening, under the authority of 49 U.S.C section 114, the Intelligence reform and Terrorism revention Act of 2004 and 49 C.F.F parts 1540 and 1560. You may also provide your Redress Number, if available. Failure to provide your full name, date of birth and gender may result in denial of transport or denial of authority to enter the boarding area. TSA may share information you provide with law enforcement or intelligence agencies or others under its published system of records notice. For more on TSA privacy policies, or to review the system of records notice and the privacy impact assessment, please see the TSA website at www.tsa.gov. I understand that the Transportation Security Administration requires me to carry a government issued identification card in order to board a flight. I have been advised that the name, date of birth and gender that appears on my identification card must exactly match the same such data that is listed on my airline ticket and in my booking records. I acknowledge that my failure to strictly comply with these requirements may result in denied boarding or an undue delay at an airport security checkpoint causing me to miss my flight. Ruppert Travel is not responsible for the issuance of travel identification such as passports and/or visas and travelers should ensure they have or have been approved for the appropriate documents before purchasing travel. I understand that if traveling internationally, I must have a valid passport and depending upon my destination and nationality, I may need to obtain one or more visas.
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Yes - I have read and will abide by the above TSA rules
I understand travel insurance has been offered to me for purchase to cover certain risks inherent in travel such as supplier bankruptcy, trip interruption and/or the inability to travel due to a medical or personal emergency. If I choose not to purchase travel insurance or if I purchase travel insurance on my own (not through Ruppert Travel, LLC), I understand that Ruppert Travel, LLC requires that I confirm or decline insurance in writing. This is to confirm that, in keeping with all applicable laws, I am instructing the above agent to purchase travel and/or travel insurance against the form of payment verbally instructed. I further understand that I have authorized this transaction and will hold John Ruppert and the Ruppert Travel, LLC agency harmless with respect to these instructions. It is understood that the above agency may request government issued photo identification and may verify the billing address of the card.
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Yes - I will be purchasing Travel Insurance through Ruppert Travel, LLC
No - I will be declining Travel Insurance
I have reviewed all booking itineraries sent to me by Ruppert Travel, LLC. I agree that all booking information is correct, including but not limited to: travel dates, itinerary schedule, airfare and/or car rental reservations, hotel, resort or cruise accommodations, optional activities and pricing.
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Yes - I agree
I verify that I will review the spelling of all names listed (and dates of birth, If shown) are correct and EXACTLY match the information as it reads on our passports or other provided identification when I receive my booking information after deposit.
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Yes - I will review these items
Federal law prohibits the carriage of certain hazardous items aboard the aircraft in your luggage and on your person and could result in a fine. By checking the box you acknowledge that you have been provided with the TSA Prohibited Items List and that you understand you may be charged a fine if you are not in compliance. You may view additional information at http://www.faa.gov/about/initiatives/hazmat_safety/ or http://safetravel.dot.gov/
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Yes - I agree to the reviewed the published hazardous item list
I have received and reviewed the separate PDF titled "Ruppert Travel, LLC - Terms and Conditions" and agree to set terms.
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Yes - I agree
Please use the following fields to enter an emergency contact for use during your travels.
Emergency Contact
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Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Email
example@example.com
Emergency Contact Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Please Complete the E-signature
Please verify that you are human
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Submit
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