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FLOMATON HIGH SCHOOL CLASS OF `20
Traveler Information
*Name of Traveler:
*Traveler Type:
Traveler above
Student
Sibling
Parent/Guardian
Other
*Gender:
Choose a Gender
Male
Female
*Date of Birth:
*Address Line 1:
Address Line 2:
Apt. or Suite No.
*City:
*State:
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*Zip Code:
*Home or Work Phone:
*Cell Phone:
*E-Mail of Parent:
*Occupancy REQUEST:
Choose a Occupancy REQUEST
Quadruple: $1,195 per person
Triple: $1,260 per person
Double: $1,380 per person
Trip Options and Details
After rooming list submission, each traveler will be billed on his/her room occupancy which may increase trip cost. Prices based on a minimum of 45 paying travelers per motorcoach.
*Would you like to add a 2nd traveler to this reservation?
Please Choose
Yes
No
*Name of 2nd Traveler:
*2nd Traveler Type:
Choose a 2nd Traveler Type
Student
Sibling
Parent/Guardian
Other
.
*Would you like to add a 3rd traveler to this reservation?
Please Choose
Yes
No
*Name of 3rd Traveler:
*3rd Traveler Type:
Choose a 3rd Traveler Type
Student
Sibling
Parent/Guardian
Other
.
*Would you like to add a 4th traveler to this reservation?
Please Choose
Yes
No
*Name of 4th Traveler:
*4th Traveler Type:
Choose a 4th Traveler Type
Student
Sibling
Parent/Guardian
Other
.
*Would you like to add a 5th traveler to this reservation?
Please Choose
Yes
No
*Name of 5th Traveler:
*5th Traveler Type:
Choose a 5th Traveler Type
Student
Sibling
Parent/Guardian
Other
.
*Would you like to add a 6th traveler to this reservation?
Please Choose
Yes
No
*Name of 6th Traveler:
*6th Traveler Type:
Choose a 5th Traveler Type
Student
Sibling
Parent/Guardian
Other
.
Comments:
Deposit and Payment Schedule
n order to secure your space, an initial, non-refundable deposit of $250 per person is required upon registering, followed by a payment schedule:
August 07, 2019; $250 per person
September 07, 2019; $200 per person
October 07, 2019; $200 per person
November 02, 2019; $200 per person
December 01, 2019; $200 per person
January 11, 2020; Remaining Balance
***DUE TO VENDOR REQUIREMENTS PAYMENTS MUST BE MADE ACCORDING TO THE ABOVE PAYMENT SCHEDULE. THANK YOU.
Travel Protection
WE HIGHLY RECOMMEND THAT EACH TOUR PARTICIPANT PURCHASE TRIP PROTECTION.
The Group Travel Insurance should be purchased/paid when the initial deposit is submitted in order to cover pre-existing conditions. Please included the cost of the insurance in your initial deposit. If insurance is not purchased within 14 days, pre-existing conditions will NOT be covered. However, you may purchase insurance up to 45 days prior to the departure date but without the pre-existing condition clause. For more information, please click the above link. It is the travelers responsibility to purchase insurance in a timely manner.
I understand that if I indicate that I would like to purchase insurance, my charges will reflect the number of travelers of the reservation and the pricing listed accordingly
www.travelleadersstudenttours.com/travelprotection
Please use this section to select if you`d like to purchase travel protection or not.
Pricing:
$74 per person for Double, Triple, or Quad Occupancy
*I would like to purchase travel protection:
Choose
Yes
No
Credit or Debit Card Information
Please refer to the Payment Schedule above for your payment information.
*Card Type:
Choose a Card
American Express
Discover
Master Card
Visa
*Amount to Charge: $
***Remember to add the cost of the insurance to the total when purchasing.
*Card Number:
*Name as it appears on Card:
*Expiration Month:
Month
January
February
March
April
May
June
July
August
September
October
November
December
*Expiration Year:
Year
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
Model Clause
**I give TLST permission to use pictures of me/my child for promotional materials if needed: social media, website, etc
Yes
Yes
No
Terms and Conditions
Payments must be made in a timely manner. Note: A late fee of $20 may be accessed if payments are not received within 7 days of the due date after initial deposit. Please refer to the above payment schedule. The payment schedule will also be on all invoices you receive.
Future credit/debit card payments are submitted via your invoice. Click on the RED PAY NOW button to submit payments. Travel Leaders Student Tours does NOT charge a card processing fee.
Checks and/or money orders may be submitted by mail to the address on your confirmation invoice. Student Tours does NOT accept cash.
Payments are neither refundable, nor transferable unless the trip is cancelled by the school.
Room occupancy and pricing is on request. After a rooming list is received from the school, every traveler’s final balance will be established based on his/her room occupancy type.
By submitting this form, you are agreeing to all terms and conditions and no money is refundable or transferable.
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