Emergency/Medical Form

Please complete a separate form for each guest.
Traveler's Information

Please fill out all sections entirely
Traveler's Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date
Please consent to text messages*

By checking this box, I consent to receive text messages from Education Revelation Inc. DBA 'Travel with Shayla' before, during, and after the trip, relating to trip details and important updates.
Who are you traveling with? This person will be regarded as your roommate. If you need a roommate, please type, "Roommate needed" in the box below. If you are rooming solo, you will be charged additional fees for single-person occupancy.
Air Travel

We will try to honor accommodations, but it cannot be guaranteed.
Seat Preference

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Payment Information

At this time, we can accept payment transfers via Zelle, Checks, and Money Orders. If you prefer to receive an invoice via PayPal or Stripe to process with a debit/credit card, it will be subject to a 5% processing fee.
What is your preferred payment method?

Zelle TransferPayPal InvoiceCheck/Money OrderStripe Invoice
Other Information
During your trip, you may have a "Free Day". If so, you would like to receive assistance with booking anything specific, please describe it below. We will reach out and try our best to accommodate you. (This will not apply to all trips)
If you have any questions, comments, or concerns, please list them here and we will answer them during a Zoom call or reach out to you directly.

Travel Information

International Travel
Travel Agreement
This Travel Agreement ("Agreement") is entered into by [Your Company Name] ("Company"), and the undersigned traveler ("Traveler"), effective as of the date last signed below. The Company and Traveler may be referred to herein collectively as the "Parties" or individually as a "Party."

1. Acknowledgment and Acceptance of Risk Traveler acknowledges that international travel involves inherent risks, including but not limited to accidents, injury, illness, theft, and unforeseen circumstances that can occur during activities such as excursions, transportation, and accommodations. Traveler hereby assumes all such risks and agrees to hold the Company harmless from any liabilities arising from these risks.

2. Limitation of Liability The Company shall not be liable for any injury, loss, damage, or inconvenience to any person or property that may arise during the trip, except to the extent that such liability cannot be lawfully excluded. This limitation of liability applies to all causes of action under the laws of any jurisdiction.

3. Refund Policy All payments to the Company are non-refundable. Traveler agrees that in the event of cancellation for any reason, including but not limited to medical issues, personal circumstances, or global events affecting travel, no refunds will be issued. Traveler is strongly encouraged to purchase comprehensive travel insurance ("Vacation Protection") to cover such eventualities.

4. Vacation Protection Traveler acknowledges that it is their responsibility to secure travel insurance that adequately covers potential losses incurred before, during, or after the trip. The Company is not responsible for any losses or expenses that could have been covered by such insurance.

5. Force Majeure The Company shall not be liable for any delay or failure in performance caused by circumstances beyond its reasonable control, including but not limited to acts of God, changes in government laws or regulations, terrorist activities, strikes, fire, flood, or other natural disasters.

6. Governing Law This Agreement shall be governed by and construed in accordance with the laws of the state of [Your State], without giving effect to any principles of conflicts of law.

7. Acknowledgment By signing this Agreement, Traveler acknowledges that they have read and understood this Agreement, agree to its terms, and are voluntarily giving up certain legal rights that might otherwise be available.
Signature*

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Date Completed*

MonthDayYear
Date

Photo and Video Release Form

Travel with Shayla
Please read the following agreement carefully and indicate your consent by checking the appropriate box below.

Consent for Use of Photographs and Videos:

I hereby grant to Education Revelation Inc., doing business as "Travel with Shayla" ("Company"), and its legal representatives and assigns, the irrevocable and unrestricted right to use and publish photographs and videos of me, or in which I may be included, for the promotional purposes of the Company. This includes but is not limited to advertisements, brochures, online content, and other prints and digital media. I also grant the Company the right to alter and composite such images without restriction.

I waive any right to inspect or approve the finished versions, including written copy that may be created in connection therewith.
Authorization Options:*

I Authorize I am at least 18 years of age, have read and understood this release form, and agree to the terms herein. I release, defend, and hold harmless the Company and its agents from any claims, damages, or liability arising from the use of the photographs or videos.I Do Not Authorize I do not grant permission to Education Revelation Inc. to use my photographs or videos.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Signature*

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Date*

MonthDayYear
Date

Emergency/Medical Form

Travel with Shayla
Emergency Contact

Please list at least two people that can be contacted in the event of an emergency.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
In order to ensure your safety and provide any necessary assistance during your trip, we kindly request that you voluntarily disclose any pertinent medical conditions or allergies. This information will be kept confidential and will only be used to assist in medical emergencies or as required by healthcare providers. If none, please fill in "None", sign, and date.
Please list any medical conditions, medications, allergies, or other health-related information that could be vital in an emergency:*
Consent for Use of Medical Information
By providing this information, I consent to its use solely for medical emergencies and necessary health-related situations during the trip. I understand this information will be treated confidentially and accessed only by authorized personnel or as required by law.*

I consent to the provision and use of my medical information as described.I DO NOT consent to the provision and use of my medical information as described.
Signature*

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Date*

MonthDayYear
Date

PASSPORT

Please lay your passport flat and upload a picture of your passport (page with your photo and passport number.) This must be an IMAGE and not a PDF.
Should be Empty:

Please complete a separate form for each guest.

Traveler's Information

Air Travel

Payment Information

Other Information

Travel Information

Travel Agreement

Photo and Video Release Form

Emergency/Medical Form

Emergency Contact

PASSPORT