Churchill Polar Bear Adventure Day Tour
Heartland International Travel & Tours
202 - 3111 Portage Avenue
Winnipeg, Manitoba, Canada R3K 0W4
Tour Date choice: Sat. Oct. 23, 2010 _____ Sat. Oct 30, 2010 ______ Sat. Nov. 06, 2010 _______
Please complete and email, fax or mail this form to us.
Guest Name(s): ________________________________________________________________________________
Street Address:_________________________________________________________________________
City: __________________________ State/Prov: Zip/Postal Code : _________________
Phone Number: ___ ____________ Bus/Cell Number: ______________________________
E-Mail Address: ____________________________________________________________________
Note: If you require flight arrangements to/from Winnipeg, and overnight hotel bookings prior to and after the tour, we would be pleased to assist. We have special stopover rates at the Winnipeg airport hotels.
Do you wish us to book hotel rooms for you? Yes _____ No ______ Check in: _______________ Check out: ______________
Do you wish us to book flights for you? Yes _______ No ______ Dep. date: ____________ Ret. Date: _____________ Dep./Ret. City: _______________
Please note any food allergies or diet restrictions: ______________________________________________________________________________
A non-refundable $250.00 CDN deposit per person is due at the time of booking.
Final payment is due August 25, 2010.
All tour participants must sign the waiver form then email, fax or mail into Heartland. Click here
Please charge my payments to: (Please circle)
Mastercard Visa
Account Number_____________ ___________________ Expiry Date /
Signature __________________________________________________________________
Insurance:
We strongly urge participants to purchase Travel Insurance. Neither Heartland International Travel & Tours nor their agents or contractors will be held responsible for missed connections, incorrect check in times, improper documentation, lost, stolen or damaged luggage. Any additional expenses caused by late or cancelled transportation carriers will be borne by the traveler. Cancellations made more than 60 days prior to departure will result in the loss of complete deposit. Cancellations made between 60 days and 30 days from departure date will result in loss of 50% of payment made. Cancellations made between 30 days and the departure date will result in the loss of complete payment made. The cost of insurance will vary depending upon what arrangements you want us to make for you. Please ask us for a quote. Click here for a general explanation of insurance coverage.
Please indicate if you require any insurance coverage for the trip. ___ Yes ___ No
If yes, select one of the following. _____ Travel Within Canada Insurance* _____ Non-medical Package Insurance
*Available to Canadian residents only
Date (s) of birth are required if you want insurance coverage __________________________________________________________________
Insurance is an important issue. If you don't want coverage we require your signature below, otherwise your Travel Request Form will not be processed.
I DECLINE ALL INSURANCE COVERAGE: Signature ___________________________________________________________ Date________________________
**Please note, weather conditions play a major role in northern activities. Heartland International Travel & Tours will endeavor to provide the tour as advertised, although schedules and costs may be subject to change without notice. Delays or changes may at times be necessary. In the event of flight delays, changes in tour or cancellations, expenses will be borne by the traveler. Refunds will not be issued. For those traveling from outside of Canada we that suggest you check Customs Regulations regarding import restrictions prior to beginning your trip.
Heartland International Travel & Tours
Toll free: 1 - 866-890-3377 or fax: 1 - 204 - 989-9636
Email: info@heartlandtravel.ca