Travel Insurance Waiver

Travel Insurance Waiver

Jennifer Curated Journeys
Your trip is a significant investment, and we recommend the purchase of travel insurance. If you choose to decline this valuable protection, you are assuming any financial loss associated with your travel arrangements. By declining to purchase travel insurance you fully understand that your travel agent is not liable or responsible for any expenses incurred as a result of cancellation or interruption, emergency medical and transportation, baggage and personal effects, flight and travel accident, and/ or rental car physical damage.

I have been offered and advised of travel protection / trip insurance options and fees by my travel agent, Jennifer Holman.
Name

First NameLast Name
Do you have your own travel insurance?
If yes, List Travel insurance and policy number
Do you want a quote for travel insurance for this trip? This would be trip insurance for this trip and often less expensive than annual trip insurance. If yes, please complete the dates of departure and return and total trip cost as well as your date of birth. I will be in contact with a quote.
Departure

MonthDayYear
Date
Return

MonthDayYear
Date
Total Trip Cost
Date of Birth

MonthDayYear
Date
If No, Reason for Decline of insurance.
Do you want to purchase ANNUAL travel insurance through Allianz?

My Products

Allianz Annual Travel Insurance Plan with $2,000 of trip cancellation insurance

$485.00 Quantity

Allianz Annual Travel Insurance Plan with $5,000 of trip cancellation insurance

$715.00 Quantity

Allianz Annual Travel Insurance Plan with $10,000 of trip cancellation insurance

$1,050.00 Quantity

Total

$0.00

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Afterpay

Email - a receipt will be email to you for your purchase
example@example.com
I decline the offer to purchase travel protection / trip insurance for me and my travel party. I understand that I am solely responsible for any cancellation penalties and out-of-pocket expenses incurred. I will also make my own separate travel, medical and any other provisions in the event of an emergency while I am traveling. I also understand that I am not protected from loss in the event of any travel vendor, travel supplier or any travel-related operator default. This waiver confirms that I voluntarily decline travel insurance and travel protection insurance for the trip described above. I understand I am solely liable for all airline fees, supplier fees, and agency fees that may apply, and I hereby release Jennifer Curated Journeys and Jennifer Holman, and its affiliate KJD Travel Group from any and all liability related to the trip described above.
I have read this document. I understand this document and all consequences resulting from my decision to purchase or decline trip protection and trip insurance.
Date

MonthDayYear
Date
Signature

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