Ta'Ja Travel Client Profile

  • Travel With Rachel

    Client Intake Form
    • Traveler Information 
    • Date of Birth
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    • Format: (000) 000-0000.
    • Date of Birth
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    • Format: (000) 000-0000.
    • Travel Details 
    • Departure Date
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    • Return Date
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    • Type of Trip
    • Other Services Needed

    • We Take your security very seriously. As such, you can be assured all submissions will be password-protected and encrypted.

  • Travel Insurance Waiver

  • By law I am required to offer you travel insurance. For this reason I require that all of my clients complete, sign and submit this Travel Insurance Form indicating that you have been offered travel insurance, and should you chose not to purchase travel insurance you accept all responsibility.


    Emergencies can happen when you least expect it. I highly recommend that you protect your vacation with a travel insurance policy. The cruise lines, airlines, hotels and tour operators all charge high penalties for cancellation, ranging from the full deposit to no refund at all. Another important fact to keep in mind is
    that that most health insurance policies will not cover you when you are out of the country. Your Travel Insurance will protect you in the following areas:
    Trip Cancellation
    Trip Delay
    Trip Interruption
    Missed Connection
    Baggage Loss, Theft or Damage
    Baggage Delay
    Emergency Medical and Dental Expenses
    Emergency Medical Transportation
    24/7 Hotline Assistance
    Please also note that in order for you to benefit from pre-existing coverage your policy must be purchased before final payment. There is no added cost to the policy for pre-existing coverage. It is also important to understand that you do NOT have coverage until you have an active policy! Pre-existing coverage will not apply to world events such as strikes, natural disasters, terrorism etc.
    Please understand that I am not a registered insurance agent, and can not legally provide specific advice or information regarding insurance.
    For information, please feel free to contact TravelGuard Insurance
    Company at 1 (866) 729-5215.

     
    I have been advised of, and understand the benefits of Travel Protection Insurance.
    I understand that I do not have any coverage until 24 hours after this form has been signed and submitted. Should I decline this protection, I understand that I will assume all financial responsibility for any expenses incurred as a result of being unable to travel, or travel disrupted for any reason as well as any medical
    expenses. I also understand that I must purchase Travel Insurance immediately to obtain maximum coverage, in order to be covered for any pre-existiing conditions travel insurance must be purchased prior to final payment has been made, and it must cover full cost of all non-refundable trip arrangements.

  • Please sign this acknowledgement to accept or decline the Travel Insurance that is being offered to you.

  • Should be Empty: