You Choose Travels LLC
4774 San Remo RD #583447
Kissimmee, FL 34758
Phone: (215) 639-3643

Travel Insurance Selection Form

Please complete the following to let us know whether or not you want Travel Insurance. Most travelers recognize the need to protect their trip investment. As part of our travel service, we recommend that all travelers purchase some form of travel insurance for the following reasons:

• Reimbursement for cancellation penalties (which can be 100% of your investment) in the event of an unforeseeable illness, injury or death of you, your travel companion or a family member.
• Reimbursement for cancellation penalties if you are called for jury duty, your home is damaged due to fire, windstorm, flood or vandalism or military leave cancelled.
• Trip Interruption due to delayed or cancelled flights.
• Reimbursement for unused portion of your trip if it is interrupted.
• 24-hour help line for any travel emergency, such as medical, lost tickets, lost passports, and other travel documents. For a full understanding of your benefits, you can request the Description of Services and Benefits.

I understand that travel arrangements are subject to non-refundable cancellation penalties and that travel insurance coverage can protect my travel investment.

Client Information

Client Name: ____________________________________________

Travel Companion Name: __________________________________

Phone Number: ___________________________________________

Email Address: __________________________________________

Booking Number: _________________________________________

Destination: ____________________________________________

Travel Dates: ___________________________________________

Travel Insurance Selection

I ACCEPT Travel Insurance Coverage

I DECLINE Travel Insurance Coverage

Client Signature: _________________________________________

Date: ___________________________