Arkansas Dolphin Swim Team
Trip Booking Form
USA Swimming Olympic Trials
Hilton Hotel, Omaha, Nebraska
June 30 – July 3, 2016
Client Details
Name
Address
Zip
Daytime Phone
Evening Phone
Emergency Contact
Address
Zip
Emergency Contact
Phone
City
Mobile
Email
Address
State
City
State
Mobile
Additional guests in room (no more than 4 people per room)
Name
Name
Name
Trip Details
Trip includes: 3 nights hotel with 3 breakfast/2 lunches.
Limit 1 room per family, every child MUST have a parent with them. Families responsible for purchasing their own event
tickets and transportation. Rooms purchased are non-refundable, non-transferable at the time of booking. You will be
required to present personal credit card for incidentals upon check in to the hotel
Travel insurance is highly recommended (please contact Stacy Bright for travel insurance recommendations)
Please return this completed booking form to Stacy Bright at stacyannbright@gmail.com in order to confirm your booking
Payment
By completing the below, I authorize Arkansas Dolphin Booster Association to charge my credit card for my trip. I agree to
pay the noted amount according to the card issuer agreement.
Credit Card number
Name as it appears on card
Expiration date (mm/yy)
Billing Address
CID #
Client Travel Agreement
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Arkansas Dolphin Booster club d/b/a/ Dolphin Swim Team and “Client”, enter into this Client Travel Agreement in
connection with Client’s proposed travel.
1.
Client agrees to be fully responsible for all costs and charges associated with the travel referenced in the
Trip Booking Form. Client agrees that all rooms purchased are non-refundable and non-transferrable.
2.
Client agrees to complete and return to the Swim Team the Trip Booking Form. Client understands that no
final travel documents will be delivered to Client until the Trip Booking Form has been completed and returned.
3.
Client understands that Dolphin Swim Team is acting as Client’s agent in making arrangements for the
travel reflected on the Trip Booking Form
4.
Client agrees that Dolphin Swim Team will not be responsible for any default or breach of contract or any
intentional or negligent actions or omissions on part of any suppliers, which result in any loss, disruption, damage, delay,
death or injury to client or any of client’s travel companions or group members. Dolphin Swim Team shall not be liable or
responsible for any of Client’s loss, injury or damage to person, property or otherwise, including but not limited to, terrorist
activities, acts of God, weather, dangers incident to the sea, fire, breakdown of machinery or equipment, acts of government
or other authorities, wars, whether declared or not, hostilities, civil disturbances, strikes, riots, thefts, pilferage, epidemics,
quarantines, medical or customs regulations, defaults, delays or cancellations of or changes in itinerary, routing or
scheduling, or from any loss or damage resulting from insufficient or improperly issued passports, visas or other documents.
Client agrees that Dolphin Swim Team will not be responsible for any failure of a supplier to provide to Client any of the
travel related services reflected on the Trip Booking Form
5.
If a dispute arises between Dolphin Swim Team and Client stemming from or related to this Client Travel
Agreement, the travel reflected on the Trip Booking Form or from any service provided by Dolphin Swim Team to the Client,
the parties agree that any dispute shall be governed by Arkansas law and shall be subject to the exclusive jurisdiction of the
federal courts in the Eastern District of Arkansas, Western Division or in the Arkansas circuit courts in Pulaski County,
Arkansas. The choice of forum is intended by the parties to be mandatory and not permissive, thereby precluding the
possibility of litigation between the parties in any jurisdiction other than the federal courts in the Eastern District of
Arkansas, Western Division or in the Arkansas circuit courts in Pulaski County, Arkansas. Each party waives any right it,
he or she may have to assert the doctrine of forum non conveniens or similar doctrine or to object to venue with respect to
any proceeding brought in accordance with this provision.
PLEASE SIGN THE FOLLOWING STATEMENT REGARDLESS OF PAYMENT CHOICE
By typing my name, I accept the terms of the attached Client Travel Agreement and have read and understand
the conditions outlined in the Trip Booking Form
Signature
Date
Click here to enter a date.
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