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West Perry High School Seniors | Universal 2020
Traveler Information
*Name of Traveler:
*Traveler Type:
*Date of Birth:
*Address Line 1:
Address Line 2:Apt. or Suite No.
*Zip Code:
*Home or Work Phone:
*Cell Phone:
*E-Mail of Parent:
*Occupancy REQUEST:
Pricing is pre-fundraising. Once fundraising money is received, the cost of the trip will be adjusted accordingly.
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 40 paying travelers.
*Would you like to add a 2nd traveler to this reservation?
*Name of 2nd Traveler:
*2nd Traveler Type:
*Would you like to add a 3rd traveler to this reservation?
*Name of 3rd Traveler:
*3rd Traveler Type:
*Would you like to add a 4th traveler to this reservation?
*Name of 4th Traveler:
*4th Traveler Type:
*Would you like to add a 5th traveler to this reservation?
*Name of 5th Traveler:
*5th Traveler Type:
*Would you like to add a 6th traveler to this reservation?
*Name of 6th Traveler:
*6th Traveler Type:
Deposit and Payment Schedule
Payment Schedule:
October 4, 2019 $250 per person
November 4, 2019 $125 per person
December 4, 2019 $125 per person
January 4, 2020 $125 per person
February 4, 2020 $125 per person
March 4, 2020 Remaining Balance
Travel 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
Please use this section to select if you`d like to purchase travel protection or not.

$52 per person for Double, Triple, or Quad Occupancy
*I would like to purchase travel protection:
Credit or Debit Card Information
Please refer to the Payment Schedule above for your payment information.
*Card Type:
*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:
*Expiration Year:
Model Clause
**I give TLST permission to use pictures of me/my child for promotional materials if needed: social media, website, etc
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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