2010 ITU Triathlon World Championships-Budapest, HU
September 8-12, 2010
Travel Request Form (Please print clearly)
Full name(s) (as shown on passport):
___________________________________________________________________________
Address: __________________________________________________________________________
City: _________________________Province:_________Postal Code: ___________________
Tel: (Res)____________________________ (Bus/Cell) ______________________________
Email Address: ______________________________________________________________
Accommodations - Hotel Rila
Hotel Rila
___ Single (1 person in room) ___ Triple (3 people in room)
___ Double (2 people in room) ___ Quad (4 people in room
____ Please match me up with someone
Age Range ____________________ Male Female Doesn't Matter (Circle one)
___ I have made my own air reservations for this competition
___ I require Heartland Travel to arrange my air reservations for this competition
Full names (as shown on the passport) of others traveling with you who also require air reservations:
____________________________________________________________________________________
Departure date: ______________________ Return date: _____________________________
Departure city from Canada: _____________________ Arrival City: ____________________
Air Canada Aeroplan #: ________________________________
Bikes:
Please indicate how many people listed on this form will be taking a bike ________
*What are the approx. dimensions of the bike box? ___________________________________
*What is the approximate weight of the bike box? ____________________________
*This information is only if Heartland Travel is making air reservations for you
For any hotel, air reservations, and insurance payments you must complete the following
*Credit card #-Visa or MC: _______________________________________ Exp date: ____/____
Name that appears on card: (please print) ________________________________________
Signature of authorization: ____________________________________________________
Travel Insurance coverage: Yes____ No____
If yes, select one of the following packages from either Travel Insurance Company:
RBC Insurance Deluxe Package ____ Non Medical Package ____
Travel Guard Gold Deluxe All Inclusive Package ____ Gold Deluxe Cancellation/Interruption ____
*Date you depart your home in Canada ____________________
*Date you return to your home in Canada ___________________
*We can only insure you for the full dates of your entire trip, not just part of it
Date(s) of birth: (For everyone needing insurance coverage-day/month/year)
______________________________________________________________________________________
Note: Insurance is a very important issue. If you do not want coverage from Heartland International Travel & Tours, we require your signature below. Please remember that if you decline coverage, any/all of your pre-paid travel arrangements (hotel, air, car, train, bus, etc.) are 100% non-refundable should you have to cancel.
I (please print name), _____________________________ decline all insurance coverage for this trip (sign below) and will not hold my travel agent, Heartland International Travel & Tours, Hotel Rila, Mercure Budapest Korona, Travel Guard, and RBC Travel Insurance responsible for any expenses incurred as a result of cancelling my trip.
Signature: __________________________________________ Date: __________________
Additional requests or special notes:
__________________________________________________________________________________________________
Contact: Shannon or Don
Heartland International Travel & Tours
202-3111 Portage Ave.
Winnipeg, Man. R3K 0W4
Toll free: 1-866-890-3377 Phone: 204-989-9630 Fax: 204-989-9636
Email bookings: donf@heartlandtravel.ca or shannonc@heartlandtravel.ca