information form

NON-CHARTER — Traveler’s Info

Please fill out the form below. The TSA info is required, as well as emergency contact information.

PASSENGER #1

Full Legal Name (please enter all information exactly as shown on passport)

First Name

Last Name

Date of Birth

MM/DD/YYYY

What best describes your gender?

Email Address

Contact Phone Number

Please include area code (and country code if applicable)

Passenger Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

PASSENGER #1 — PASSPORT INFORMATION

US Citizens must travel with passport that is valid for at least 6 months beyond their return date. Non-US citizens please check with the corresponding consulates of each country for their specific visa requirements.

If the information above does not match the passport, all fees incurred for any changes to the airline reservation record are the passengers’ responsibility. If this form is filled out by 3rd party (travel agent), agent agrees that all information provided is correct and accepts responsibility for all fees incurred for any changes to the airline reservation record due to incorrect information.

Passenger Passport Number / Expiration Date

Passport Issued Date

Passport Issuing Country

PASSENGER #1 — TSA SECURE FLIGHT INFO (REQUIRED)

USA Homeland Security and TSA require airlines to provide additional passenger documentation information in all air reservation records. Each person for whom we book air arrangements must comply with this regulation. Failure to provide TSA information on time may result in change fees, airline record cancellation or denial of boarding. If you wish to email or fax us a copy of the passport for each passenger, in lieu of using this form, please contact us. Emergency contact information is required.

Known Traveler Number (TSA Pre-Check)

Global Entry Number

EMERGENCY CONTACT

Emergency Contact Information (REQUIRED prior to release of documentation)

Please note in the event of emergencies, you authorize Te Mana Travels and its representatives to contact and share information with the below contact, including but not limited to your travel itinerary and medical conditions.

Name of Passenger’s Emergency Contact / Relationship to Passenger

Emergency Contact Phone Number

Please include area code (and country if applicable)

Emergency Contact Email

OTHER PASSENGERS

For each passenger, please fill out full legal name (exactly as shown on passport), date of birth, gender, email address, contact phone number, address and country (if different from Passenger #1), passport number, expiration date, issue date, issuing country, TSA known traveler number (TSA pre-check) and global entry number, and emergency contact info (if different from Passenger #1). UPLOAD PHOTO OF PASSPORT ID ABOVE.

PASSENGER #2

PASSENGER #3

PASSENGER #4

PASSENGER #5

CONFIRMATION & VERIFICATION

Travel Insurance Acknowledgement

Emergencies can happen when you least expect them. Te mana Travels highly recommends that all clients purchase a travel insurance policy to protect their investment. Cruise lines, airlines, hotels, and tour operators all charge high penalties for cancellation, ranging from the full deposit to no refund at all. And, keep in mind that most health insurance policies will not cover you when you are out of the country. Travel insurance can protect you in the event of Trip Cancellation, Trip Delay, Trip Interruption, Missed Connection, Baggage Loss, Theft or Damage, Baggage Delay, Emergency Medical and Dental Expenses, and Emergency Medical Transportation, among other unforeseen circumstances. Please also note that in order for you to obtain coverage for certain pre-existing conditions, or for supplier default, your policy must be purchased at the time of booking or shortly thereafter (depending on the terms of the policy). Please understand that we are not registered insurance agents and cannot legally provide specific advice or information regarding insurance. We will gladly secure a quote for you, upon request, and if Te Mana Travels does not, or is not legally able to secure coverage on your behalf, it is our strong recommendation that you purchase a policy on your own. By clicking ‘I Agree’, I acknowledge that Te Mana Travels has recommended or offered travel insurance protection to me. Should I choose not to purchase such a policy, I accept all responsibility for declining to secure coverage.

I acknowledge that Te Mana Travels has recommended or offered travel insurance protection to me.

I agree

Electronic Signature (REQUIRED)

I agree to all Te ManaTravels and/or Third party Terms and Conditions. If the information above does not match the passport, all fees incurred for any changes to the airline reservation record are the passengers’ responsibility. If this form is filled out by 3rd party (travel agent), agent agrees that all information provided is correct and accepts responsibility for all fees incurred for any changes to the airline reservation record due to incorrect information. Typing your name exactly as it appears below signifies you are completing this form using an electronic signature. By signing electronically, you are certifying that you have read and understand the TSA form and agree to sign electronically. You also agree to receive required disclosures or other communications related to this electronic transaction. TO CONTINUE WITH THE ELECTRONIC SIGNATURE PROCESS, PLEASE ENTER YOUR NAME AND CLICK THE "SIGN ELECTRONICALLY AND SUBMIT" BUTTON TO SAVE YOUR INFORMATION AND SUBMIT YOUR ELECTRONIC SIGNATURE.

PASSENGER #1 — NAME

First Name

Last Name

Date Signed

YYYY