Travel Insurance Waiver Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Name of Trip * Dates of Trip * Destination * Your Travel Advisor First and Last Name * Booking/Confirmation Number or Date I decline the offer to purchase travel protection / trip insurance through Let's Travel Together LLC. I understand that I am solely responsible for any cancellation penalties and out-of-pocket expenses incurred. I will also make my own separate travel, medical and any other provisions in the event of an emergency while I am traveling. I also understand that I am not protected from loss in the event of any travel vendor, travel supplier or any travel-related operator default. This waiver confirms that I voluntarily decline travel insurance and travel protection insurance for the trip described above. I understand I am solely liable for all airline fees, supplier fees, and agency fees that may apply, and I hereby release Let's Travel Together LLC and its agents from any and all liability related to the trip described above. * Name * Please type your name to sign and agree with waiver First Name Last Name Today's Date * MM DD YYYY Thank you for your form submission.You have declined travel protection for your next trip.Should this information be incorrect please contact your travel advisor immediately.Thank you!