Trip Cancellation Insurance Waiver
USTA Number
*
Must be 6-digits
Name
*
First Name
Last Name
Email
*
example@example.com
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USA Tour strongly recommends that I, {name}, purchase on behalf of myself, and other family members, a Travel Cancellation Insurance Policy.
*
I HAVE PURCHASED a Trip Cancellation Insurance Policy
I DECLINE the purchase of a Travel Cancellation Insurance Policy
Insurance included in the USA Tour package:
Accidental death and dismemberment
Medical Evacuation and Repatriation
Medical Expense
Acknowledgement
*
I agree that the United States Twirling Association shall not be liable, and I expressly waive and release the United States Twirling Association and their respective officers, directors, agents, successors, or assigns from any direct or indirect incidental, consequential, special, punitive or exemplary damages or losses, whether in contract or otherwise.
Signature
*
List other family members who decline Trip Cancellation Insurance:
Submit
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