Trip Registration Form

Trip Registration Form

Paris Noir

with

Politics and Prose
1)Passenger Details:

(Your name must match exactly the one on your passport )
Full Name Traveler #1 Exactly as it appears on your passport*

PrefixFirst NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone Number

Area CodePhone Number
Mobile / Travel Phone Number*

Area CodePhone Number
E-mail*
Rooming with:
Full Name

PrefixFirst NameLast Name
Room Type
Single occupancyDouble occupancyTwin Beds
(2) Payment
Cashiers CheckCredit Card (please note: a 3.5% or 5%(AmEx) will be added to your payment)
3) Insurance:

We are obliged by law to offer travel insurance to all travelers. Once registered, you will receive insurance information. We strongly advise purchasing travel insurance.
4) Active Travel Advisory
Yes
Excursions on this program require Active Travel:
-walking distances up to 3-5 miles
-walking on cobblestones, unpaved paths and/or uneven surfaces
-getting on/off trains, cars or vans
-most of the transportation to sites will be by public transportation. Navigating 10-40 stairs and corridors of varying lengths to get in/out of Métro stations
-standing and walking 1-2 hours
5) Special Needs
Do you have mobility challenges, food allergies, or other special needs
6) Declaration:
__ I understand that it is my responsibility to obtain the correct travel documentation (passport, visa, identification) for the destination(s) to be visited.
__ I understand that the names printed on this registration must match exactly the first and last names in each passport.

__ I acknowledge that the passports of each traveler must be valid six months from the date of travel
Any discrepancy may result in cancellation, change fees, new and higher airfares or denial of services.

__ I have read the Terms and Conditions for this trip.

__ I understand the refund policy outlined in the Terms and Conditions should I cancel this trip for any reason.

___My payment and siqnature below constitute acceptance of these terms. I will be offered insurance.
Signature. (Hold down space bar and manoeuvre the mouse to sign)*
Should be Empty:

1)Passenger Details:

Room Type

(2) Payment

3) Insurance:

4) Active Travel Advisory

5) Special Needs

6) Declaration: