booking form

Nanuk Polar Bear Safari

Heartland International Travel & Tours

202 - 3111 Portage Avenue

Winnipeg, Manitoba, Canada R3K 0W4

2011 Tour Dates (please check): ___ Aug 24 - 30 ___ Aug 28 - Sept 3 ___ Sept 1 - 7 ___ Sept 20 - 26 ___ Sept 24 - 30

Please complete and fax or mail this form to us.

Guest's Name: ________________________________________________________________________

Address: _____________________________________________________________________

City: __________________________ State/Prov: Zip/Postal Code : _________________

Phone Number: ________ Cell/Bus Number:_____________________________________

E-Mail Address: ____________________________________________________________________

Note: If you require flight arrangements to Winnipeg we would be pleased to assist. Please indicate if you want us to make these arrangements for you.

Flights: Yes ___ No ___

Departure City: _______________ Departure Date: ____________________ Return Date: ____________________

A non-refundable $1500.00 CDN deposit per person is due at the time of booking. Final payment is due 90 days prior to tour date.

Please charge payments to my: MasterCard ___ Visa ___

Card Number___________________________________________ Expiry Date ____/____ Date: _________________

Name on Card (please print): _____________________________________

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. ___ Yes ___ No

If yes, select one of the following. ___ Travel within Canada Insurance ___ Deluxe Package Insurance ___ Non-medical Package Insurance

Date (s) of birth are required if you want insurance coverage (dd/mth/year) _____________________________________

Insurance is an important issue. If you don't want coverage we require your signature below, otherwise your booking 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

Nanuk Polar Bear Safari

Heartland International Travel & Tours

202 - 3111 Portage Avenue

Winnipeg, Manitoba, Canada R3K 0W4

Optional Insurance Package: This coverage is strongly recommended. Please note that for some previous tours, passengers declined the purchase of insurance and subsequently had to cancel their travel plans due to unexpected accidents.nobody plans to have an accident. Air and hotel cancellation penalties took effect and considerable sums of money were lost. See what type of coverage is applicable to you and then make your decision accordingly.

1.) Travel within Canada Insurance / Deluxe Insurance Package : Available only for Canadian residents who have coverage under a provincial health plan

Travel Within Canada Insurance and Deluxe Package Insurance covers you for emergency medical costs that you may incur while you are on your tour; it also covers for any cancellation penalties you may be required to pay in the event that you have booked and paid for everything, and then can't go due to an unexpected medical reason. The key word is "unexpected"... the insurance will not cover for existing medical situations, or if you simply change your mind and don't want to go. In addition, the insurance will also cover you if someone in your immediate family becomes ill, due to unexpected medical reasons, and this prevents you from traveling. Terms and conditions are as per RBC's insurance policy. In the event of a claim, RBC Insurance will require a doctor's certificate to substantiate the claim.

Travel within Canada Insurance covers for the following:

* Trip cancellation & interruption (i.e. covers for air and / or hotel cancellation penalties that may apply)

* Subsistence allowance of up to $3500.00 at the destination if you cannot return as originally scheduled

* Unlimited hospital, medical coverage

* Air flight accident insurance up to $100,000

* Travel accident insurance up to $50,000

* Baggage & personal effects insurance up to $1000.00, and delay of baggage up to $400.00

2.) Non-medical Package Insurance:

This option is for those who already have extended medical coverage or for Non-Canadians. You are insured for everything that the Travel within Canada Insurance covers, as shown above, except for unlimited hospital, medical expenses.

The following sample insurance rates are based on the cost from Winnipeg. For those with airfares in and out of Winnipeg, higher rates may apply and can be requested. Policy exclusions apply as far as pre-existing medical circumstances are concerned. Terms and conditions are as per the policy issued by RBC Insurance.

Travel within Canada Insurance: (For Canadian Residents only) Age

Coverage from 5 - 9 days up to 59 60-64 65-69 70-74

Rates: $296 $346 $395 $459

Deluxe Insurance Package (For Canadian Residents only) Age

Coverage from 5 - 9 days up to 59 60-64 65-69 70-74

Rates: $312 $376 $456 $569

Non-medical coverage, for those with their own medical insurance or for Non-Canadians, is available as follows:

Non-Medical Package Insurance: Age

Coverage from 5 - 9 days up to 59 60-64 65-69 70-74

Rates: $291 $341 $389 $452

Note-the above rates are based on 5-9 days of coverage and coverage up to $6400.00 CAD. If your tour is longer in duration and more expensive, these rates will not pertain to you. Please contact us for rates regarding your trip so we can make sure that you are 100% covered. Premiums taxable at 8% when sold to Ontario residents.

Above rates may be subject to change.