Non-Cruise Adventure Authorization Form

Please provide the below information for all Travelers:
(Names must match Passport/Photo ID exactly)

Passenger Name*: DOB*:
I have a Passport. Country Passport Number Exp
Check all that apply:Food AllergiesFood SensitivitySharps Container
Other:

Passenger Name: DOB:
I have a Passport. Country Passport Number Exp
Check all that apply:Food AllergiesFood SensitivitySharps Container
Other:

Passenger Name: DOB:
I have a Passport. Country Passport Number Exp
Check all that apply:Food AllergiesFood SensitivitySharps Container
Other:

Passenger Name: DOB:
I have a Passport. Country Passport Number Exp
Check all that apply:Food AllergiesFood SensitivitySharps Container
Other:

By signing below, I acknowledge and accept this charge to my credit card. I also acknowledge that Ships and Trips acts only as a booking agent, other participating organizations act solely as other agents in arranging for transportation, hotel accommodations and other services. We do not assume, and in fact, we expressly disclaim any liability for injury, damage, loss, accident, or delay due to any act negligence or default of tour guide, or any company or person engaged in transporting the passengers, or rendering any services, or carrying out the arrangements or any tour, or their agents, servants and employees. Any and all disputes or claims concerning this contract must be resolved exclusively between the parties by submitting the dispute or claim in binding arbitration in the State of California.

Travel Insurance*:
I acknowledge that I have been offered trip cancellation insurance or travel insurance,
No, I'm Not interested in trip cancellation or travel InsuranceYes, I would like to purchase travel insurance. Please forward my options to the above e-mail

I am interested in a payment plan.

Cardholder Signature (use mouse to draw signature inside box below)