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FOR OFFICE USE ONLY en ART ED OirrPosr,,,, i3 SAFARI & TRAVEL CO. 44 1 TRIP CANCELLATION POLICY & INSURANCE WAIVER TRIP CANCELLATION POLICY Date received Date of trip Travel speciaist In the spirit of our ongo

Date of trip Travel speciaist In the spirit of our ongoing commitment to ensuring your total comfort with every aspect of your travel experience. Uncharted Outposts continues to work on your behalf to protect your vacation investment. Cancellation of a booking must be in writing to Uncharted Outposts. Cancellati

FOR OFFICE USE ONLY Dale received Date dole 'esti specialist 13.s el-IARTED OUrpo s SAFARI & TRAVEL CO. PERSONAL INFORMATION FORM PERSONAL INFORMATION PASSPORT INFORMATION Name (as appears en yew passport) Passport Number Mailing Address National

g, or other outdoor experience: Please list any special occasions while on your trip: DOCTOR INFORMATION Name Address: Telephone: City: Zip: Uncharted Outposts I p: 505.795.7710 I I: 505.795.7714 I EFTA00602050

FOR OFFICE USE ONLY Date teethed Dale of trip bawl specialet los el-IARTED OUrpo s SAFARI & TRAVEL CO. PERSONAL INFORMATION FORM PERSONAL INFORMATION PASSPORT INFORMATION Name (as appears on yew passport) Passport Number Mailing Address National

rseback riding, or other outdoor experience: Please list any special occasions while on your trip: DOCTOR INFORMATION Name Address: Telephone: Uncharted Outposts I City: Zip: EFTA00728789

FOR OFFICE USE ONLY Dalereceived Dan at trip Wall socialist 13s CIIARTED OUTpO s SAFARI & TRAVEL CO. PERSONAL & MEDICAL INFORMATION FORM Tie PERSONAL INFORMATION PASSPORT INFORMATION Name Re amens re your passport) Passport Number Mailing Addres

riding. or other outdoor experience: Please list any special occasions while on your trip: DOCTOR INFORMATION Name Address: Telephone: City: Uncharted Outposts I p: 505.795.7710 I f: 505.795.7714 I www.unchattedOutposts.com EFTA_R1_01520596 EFTA02444230

.0s CIIARTED OUTPOs SAFARI & TRAVEL CO. TRIP CANCELLATION POLICY & INSURANCE WAIVER TRIP CANCELLATION POLICY FOR OFFICE USE ONLY Date received Date of top Travel specialist In the sp

Date of top Travel specialist In the spirit of our ongoing commitment to ensuring your total comfort with every aspect of your travel experience. Uncharted Outposts continues to work on your behalf to protect your vacation investment. Cancellation of a booking must be in writing to Uncharted Outposts. Cancellati

NAME ON CARD tialotTED OUTPOSTS SAFARI & TRAVEL CO. ? FS CREDIT CARD AUTHORIZATION FORM FOR OFFICE USE ONLY Date receited ot VIP Travel spedakt (Please Print) Type of Card: O Visa El Master

edit card for purchase of travel Insurance. Mailing Address: (as appears on your billing statement) Street City State Zip I do hereby authorize Uncharted Outposts to charge my credit card in the amount of US Dollars for my travel arrangements and take full responsibility for the above charges. Cardholder's Si