Travel Confident Menu


Trip Cost *
(per person)
Protection
(per person)
Up to $500    =   $35
$501-$600    =   $45
$601 - $700    =   $59
$701 - $1100    =   $69
$1101 - $1500    =   $94
$1501 - $2000    = $129
*For full benefit eligibility you must protect the full cost of the trip.


  

Protection Plan Application Form


Please fill out the Protection Plan Application Form below. You may add as many as 10 passengers to the form. Fields with an '*' indicate required fields. Upon completion click 'Submit My Application Form' to complete your application.

** Please enter the passenger who is paying as the first passenger.

Your Trip Information

Destination: Niagara Falls & Toronto (Tour ID: 1542004)
Trip Dates: 6/14/2020 - 6/20/2020
Departing From: Park Forest, IL Group Leader: Adina

Protection Plan Application Form

* After entering your name, please select your Occupancy: either 'Double', 'Single' or 'Triple' Occupancy. This is the cost of the trip for each person. Upon selecting your occupancy, after a brief delay, the Cost of Protection will appear to the right. If you wish to remove a person, click the bubble under 'Reset'? to remove the person on that line.

** Click here to add more than 4 passengers

First Name* Last Name* Double Single Triple Reset? Cost
$689 $923 $669
First Name* Last Name* Double Single Triple Reset? Cost
$689 $923 $669
First Name* Last Name* Double Single Triple Reset? Cost
$689 $923 $669
First Name* Last Name* Double Single Triple Reset? Cost
$689 $923 $669

Total Cost: $0

Your Credit Card Information

*First Name: *Last Name:
*Address: Suite/Bldg:
*City: *State/Zip:
*Phone Number:  (NOTE: Please only use numbers, no characters)
*Credit Card #: *Credit Card:
*Expiration:
*Email Address:   (Ex: someone@yahoo.com)
 




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