Gates Chili Middle School

 

 

GATES CHILI MIDDLE SCHOOL – 8th GRADE

TRIP REGISTRATION FORM FOR TRAVELING STUDENT NIAGARA FALLS, NY

JUNE 7, 2024

 

PRINT STUDENT’S LEGAL NAME:  

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ADDRESS:                                                                                                                   

 

CITY:                                                                           

STATE:                    ZIP:                           

 

HOME PHONE:                                                                                   

 

PARENT’S CELL PHONE:                                                                                     

 

PARENT’S EMAIL:                                                                                                 

 

STUDENT’S DATE OF BIRTH:                                                       

GENDER:                   

 

PRINT PARENT’S NAME:  

 

VEGETARIAN:                   YES

              NO

 

DIETARY RESTRICTIONS:                                                                                       

 

1st Choice Educational Tours Policies & Procedures

 

RATE INFORMATION: All trips are priced based on your estimated number of participants.  If the group size falls below the guaranteed number, prices will be adjusted accordingly.  Prices reflect current fuel prices. The motor coach company, train and/or airline company reserves the right to add a fuel surcharge to the final price if over the applicable service date fuel prices have increased significantly from the date of contract agreement. Initials          

 

PAYMENT TERMS: A booking fee is required per person and calculated into the deposit to ensure space on a contracted trip. One day trip - $25.00 / Two day trip - $50.00 / Three day trip & over - $75.00. The booking fee is non-refundable and non-transferable.  Final payment is due at 1st Choice Educational Tours 60 days prior to the trip departure date.  If a trip is booked within 60 days of the departure date, one lump sum payment will be required upon booking. Initials        

 

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GATES CHILI MIDDLE SCHOOL – 8th GRADE

 

REFUNDS: The $25.00 booking fee is non-refundable and non-transferable. A person unable to attend the trip is encouraged to find a school approved replacement to avoid the loss of monies paid.  Participants who cancel and do not arrange for a replacement will be sent a refund after the return of the trip equal to the value of the refundable unused meals and admissions.  Transportation, lodging, prepaid admissions, and all administrative booking fees are not refundable.  Optional cancellation insurance is available and suggested. Initials                                                                                                                                                                            

 

RESPONSIBILITY: 1st Choice Educational Tours, a division of First Choice Travel, Inc. acts as an agent for educational and travel related suppliers in all matters relevant to transportation, entertainment, attractions, sightseeing, and other tour-related features.  As an agent, 1st Choice Educational Tours has no control over the personnel, facilities or equipment of such suppliers and accepts no responsibility or liability for loss, damage, personal injury, accident, inconvenience, delay or irregularity, regardless of the cause, related to or during a trip. 1st Choice Educational Tours retains the right to substitute any tour component with another of comparable or better value. 1st Choice Educational Tours recommends cancellation insurance. Initials                                                                                                          

 

Any check returned by the bank for any reason will result in a $20.00 service charge. Initials               

 

Your signature and initials indicate that you have read, fully understand and are in agreement with the terms and conditions.

 

PARENT’S SIGNATURE:  

DATE:                             

 

IMPORTANT:

 

MAKE SURE TO INITIAL IN FIVE PLACES THEN SIGN. INCOMPLETE FORMS WILL NOT BE ACCEPTABLE.

 

NO STUDENT WILL BE REGISTERED FOR A TRIP WITHOUT THE COMPLETED AND SIGNED REGISTRATION FORM.

 

TRAVEL GUARD ELECTION FORM FOR TRAVELING STUDENT GATES CHILI MIDDLE SCHOOL – 8th GRADE

NIAGARA FALLS, NY JUNE 7, 2024

 

MUST BE COMPLETED AND RETURNED

 

First Choice Educational Tours is pleased to offer travel insurance protection from Travel Guard International.

Please refer to the provided coverage overview.

Unforeseen circumstances can arise and often do. Emergencies can occur before departure or while you are traveling. We highly recommend this travel insurance and urge you to give it careful consideration.

 

I have been offered Travel Guard protection for my trip and have chosen:

 

OPTION #1 - Purchase the insurance offered. A check in the amount of $9.15 should be made payable to 1st Choice Educational Tours and paid at the time of deposit payment in order for the waiver of Pre- existing Medical Condition Exclusion to be included.

 

OPTION #2 - Purchase the Optional Coverage – Cancel for any reason. The insurer will reimburse 50% of non-refundable expenses if you cancel your trip for any reason, up to 48 hours prior to your departure. This coverage can only be purchased at the time of deposit payment. If you are purchasing this coverage the check should be in the amount of $12.08. You do not have to pay for option #1 if you select this option.

 

OPTION #3 - Decline to purchase the insurance option #1 or option #2 that is being offered. I fully understand that by declining to purchase travel insurance, 1st Choice Educational Tours cannot be held responsible for any expenses incurred by me that would have been covered by this travel insurance.

 

Please select one of the options above, complete the information below, sign and return to Gates Chili Middle School. No student will be registered for a trip without the completed and signed Travel Guard election form and registration form. If you wish to purchase the insurance, please send the check for the insurance to the school with your check for the deposit.

 

 

Parent’s Name Printed

 

 

 

Signature                                                          Date

 

Student’s Name  

 

Street Address                                                                                            

 

 

                                                                                                                                      

City                                                         State                  Zip Code

 

 

Confidence makes a great traveling companion.

Because no matter how hard you try, there are some things you just can’t plan for. Make sure you pack a Travel Guard Student Travel Protection Plan which provides valuable coverage, at an affordable price, and to help bring home amazing travel memories, not unexpected expenses due to travel mishaps.

 

Travel Smart with Travel Guard.

 

You can be covered:

• if you incur medical expenses, for an unforeseen injury or sickness, during the course of your trip.
• if you have to return home early due to an unexpected emergency such as an illness or death in the family.
• if your luggage is lost or delayed, forcing you to purchase necessary essentials.
• if you need an emergency medical evacuation due to an accident or sudden illness.

To view a full listing of coverage benefits, please refer to the Policy of Insurance.

 

QUESTIONS?

CALL TOLL-FREE:

1.877.254.8922

 

 

 

 

                 THIS IS A BRIEF DESCRIPTION OF COVERAGE – LIMITATIONS APPLY                 

 

Coverage may not be available in all states. Coverage varies by state. For complete coverage information and exclusions, please refer to the Policy of Insurance for your state of residency prior to purchase, by visiting  www.travelguard.com/policy/student.

 

COVERAGE

EXTRA COVERAGE

 

 

Per Person Maximum Limit Up To   Trip Cancellation1 100% of Insured Trip Cost (Maximum of $25,000)   Trip Interruption1 150% of Insured Trip Cost (Maximum of $37,500)   Single Occupancy 100% of Insured Trip Cost (Maximum of $25,000)   Trip Delay $500                                                                                                       (Maximum of $100 per day, 12 HRS)     Baggage Coverage $1,000 (Primary) Baggage Delay $100 (24 HRS) Travel Medical Expense/ Dental Expense $50,000 (Primary) $500 Emergency Evacuation and Repatriation of Remains   $500,000 Ancillary Evacuation Benefits (including Baggage Return, Return Transportation and Bedside Visit)   $2,500 Non-flight Accidental Death & Dismemberment   $30,000   Assistance Services2 Travel Medical Assistance Worldwide Travel Assistance     Included

Pre-Existing Medical Condition Exclusion Waiver (Policy must be purchased within 15 days of the Initial Trip Payment. Day one is the date the initial payment is received. If the policy is not purchased within 15 days of the Initial Trip Payment, then a 60-day look-back period applies. For residents of ID, MN and NY, the look-back period is 180-days.)

 

 

OPTIONAL COVERAGE

 

 

Cancel for Any Reason, up to 50% of Trip Cost3 (Must be purchased within 15 days of Initial Trip Payment.)

 

 

Coverage available to U.S. residents of the U.S. states and District of Columbia only. This plan provides insurance coverage that only applies during the covered trip. You may have coverage from other sources that provides you with similar benefits but may be subject to different restrictions depending upon your other coverages. You may wish to compare the terms and conditions of this policy with those of your existing life, health, home and automobile insurance policies, as well as any coverage which may be available to you through your credit card program(s). If you have any questions about your current coverage, call your insurer or insurance agent or broker. Coverage is offered by Travel Guard Group, Inc (Travel Guard). California lic. no.0B93606, 3300 Business Park Drive, Stevens Point, WI 54482, www.travelguard.com. CA DOI toll free number: 800-927-HELP. This is only a brief description of the coverage(s) available. The Policy will contain reductions,   limitations,   exclusions   and   termination   provisions.   Insurance

                                                                                                                           underwritten by National Union Fire Insurance Company of Pittsburgh, Pa., a

Pennsylvania insurance company, with its principal place of business at 1271

Expenses incurred from third-party vendors for assistance services not part of a filed insurance plan are the responsibility of the traveler.

1. Coverage only applicable to prepaid, non-refundable trip costs identified on the enrollment form and if the required plan cost has been paid.
2. Non-insurance services are provided by Travel Guard.
3. Cancel for Any Reason is available as a service to residents of NY.

Avenue of the Americas, 37th FL, New York, NY 10020-1304. It is currently authorized to transact business in all states and the District of Columbia. NAIC No. 19445. Coverage may not be available in all states. Your travel retailer may not be licensed to sell insurance, and cannot answer technical questions about the benefits, exclusions, and conditions of this insurance and cannot evaluate the adequacy of your existing insurance. The purchase of travel insurance is not required in order to purchase any other product or service from the travel retailer. Travel assistance services provided by Travel Guard.