Travel Insurance Waiver/Acceptance Agreement - Sample
Below is a sample of our travel insurance acceptance/waiver agreement.
TRAVEL INSURANCE ACCEPTANCE/WAIVER
AGENCY ROLE
Unwind Adventures, LLC (“Agency”) is NOT an insurance agent or provider. We offer
travelers the opportunity to purchase travel insurance through third parties. We take all
reasonable measures to advise travelers of: (1) cancellation fees, change fees, and other
potential fees relating to travel services provided by third-party suppliers, some of which
may be non-refundable; and (2) the inherent risks in travel.
TRAVELER ROLE
You are responsible for: (1) understanding the potential costs and risks of travel; and (2)
accepting or declining travel insurance, either at the time of purchase or, if permitted by
travel insurance providers, prior to the final due date of travel payments.
You are responsible for reading and understanding: (1) all details and terms regarding
your travel itineraries; (2) all components of travel insurance coverage under the policies
you may choose; and (3) all matters related to this Travel Insurance Acceptance / Waiver.
You warrant that you are 18 years of age or older and have authority to sign and accept
this Travel Insurance Acceptance / Waiver on behalf of all minor and adult travelers on the
same booking who reside in your household.
If you have any questions or if you have not received a quote for travel insurance, please
contact us.
INSURANCE AGENT OR PROVIDER ROLE
Insurance agents and providers make available travel insurance to travelers in exchange
for fees. Travel insurance and coverage of claims differ based on the type of travel and
terms of each insurance policy.
TRAVEL INSURANCE OPTIONS
You must choose ONE option below:
YES, I AGREE TO PURCHASE TRAVEL INSURANCE (VIA CREDIT OR DEBIT CARD).
I have read, understand, and accept the travel insurance quote(s), policy, and coverage
offered to me.
I authorize Agency to charge the quoted amount to my credit or debit card.
The travel insurance policy I choose may exclude coverage relating to certain matters,
including without limitation: (1) pre-existing medical conditions; (2) trip interruptions
relating to any pandemic or epidemic; and (3) risk locations and activities.
My decisions regarding travel insurance apply to me and all minor and adult travelers on
the same booking who reside in my household.
NO, I CHOOSE TO DECLINE TRAVEL INSURANCE.
I understand the travel insurance quote(s) offered to me, but I choose to DECLINE travel
insurance.
By DECLINING travel insurance, I understand and agree to the following:
I waive all insurance protection and assistance from Agency relating to my travel,
including without limitation: (1) travel changes, interruptions, or cancellations; (2)
baggage delays or loss; (3) travel supplier defaults; (4) medical costs; (5) accidents and
emergencies; and (6) any other loss, cost, injury, or death that may arise; and
I may lose up to 100% of the cost of my travel bookings, plus any cancellation or related
fees charged by Agency and third-party travel suppliers; and
I accept all risk of loss, cost, injury, and death relating to my travel; and
I release from all liability and waive any claim against Agency, its owners, directors,
employees, contractors, advisors, and successors and assigns regarding any loss, cost,
injury, or death relating to my travel and my election to decline travel insurance; and
My decisions regarding travel insurance apply to me and all minor and adult travelers on
the same booking who reside in my household.
SIGNED: _____________________________________
NAME: _______________________________________
DATE: ________________________________________
