Trip Cancellation Insurance Waiver Form

(CONFIDENTIAL) - Please fill out and hit "SUBMIT" at bottom of form It is the policy of Spears Travel to recommend travel insurance to all of our clients. Although many people do not feel that travel insurance is important, we feel it is a mandatory ingredient to a worry-free vacation.

Please select one of the following: (Choice of 4)(Required)

I have purchased insurance directly with a Spears Travel agent

I have travel purchased insurance directly online at www.spearstravel.com

I have purchased insurance from another vendor

I acknowledge receiving information about trip cancellation insurance from Spears Travel and herby declare by acknowledgement (submit) of this form that I declined at this time to purchase the optional insurance.

Policy #(Required)

Name(Required)

First Last

Email(Required)

Phone

Trip Departure Date

Name of Travel Consultant (if known)

By clicking "Submit" you agree you have read this form in its entirety.

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You may also print and sign and return to:
Spears Travel/Travel Leaders
P.O. Box 1256
Bartlesville, OK 74005
Fax 918-337-3630
email: groups@spearstravel.com

SIGNATURE ____________________________________