Travel Insurance Waiver Form

TRAVEL INSURANCE WAIVER FORM

By completing and submitting this form you hereby acknowledge that you have been offered the opportunity to purchase travel insurance by your Vacation Designer and have decided to decline this option. You also acknowledge that by doing so Vacations By Design cannot be held responsible for any consequences that arise as a result of not having purchased the travel insurance we have offered.

Before submitting this form, if you would like to have a further look at the travel insurance options we offer, please visit our preferred Travel Insurance provider by clicking on the Allianz logo.....:

* Indicates required field

Todays' Date *

Name *

First

Last

Email *

Travel Date (xx/xx/xx) *

Please Select Your Travel Designers' Name *

Click to Submit your Travel Insurance Waiver Form