JCCAA Leisure Learning Club 2016 Trip
Discover the Spectacular Eastern Europe & Russia 2016
Luxury Guided Trip with Hotel, Tour Bus, Cruise, local Airport/Hotel Transportation, show tickets and all Meals
Registration: Before 12/1/15 with Registration/Liability Waiver Form, payment and passport photocopy
Final Payment Due Date: December 1, 2015
Limited Space, first come first serve
Early Bird Bonus: LLC members who complete their registration and postmarked:
Land + International Air: $200 by 10/15/15, $100 by 11/15/15 Land only: $100 by 11/15/15
Group
Trip
Date
Land Only
Air + Tax + Fuel Surcharge
Title Passport Name
Pre-Trip
A
Munich
Eastern Europe
5/10/16-5/12/16
5/12/16-5/24/16
$500
$2,799
$1200-$1400
Chinese Name
Date of Birth
B
Eastern Europe & Russia
5/12/16-5/29/16
$4,699
$900-$1100
Passport #
Expiration Date Citizenship
1.__________________________________________________________________________________________
2.__________________________________________________________________________________________
Mailing Address: (NO P O BOX) ___________________________________________ City __________________
State: ______ Zip
_
Home Phone: (_______) _________________
Email Address: ______________________________________
Cell Phone:
(_______) _______________________________
Emergency Contact Name___________ Phone _____________ United Mileage# __________________________
Grp A $2799: □
Group B $4699: □
Pre- Trip $500: □
Deposit: $2000 per Person X ______ = $ __________
Total Check Amount: $ _____________
Air Tickets: □
Non-LLC Member: $50 X ________ = $ __________
Check #: _____________
Check Date: _____________
Trip Cancellation Policy
● 12/1/15 to 12/31/15- $100 ● 1/1/16 to 1/31/16- $200 ● 2/1/16 -2/28/16 - $300
● 3/1/16 to 3/31/16 – No refunds; name changes $300 + air penalty ● No Refund or changes after 4/1/16
Price includes: Guided Land Tour, International (if apply) & domestic Airfare/tax/fuel surcharge, Hotel, Tour Bus, Cruise
Airport/Hotel Transportation, entrance Fees, show tickets and all Meals.
Price does not includes: Gratuities, Trip Cancellation Insurance, Personal expenses
International Air Tickets Cancelations: According airline cancelation policy after issue the tickets.
I agree to inform the Tour Group Leader of all charges and special requirements required. I understand that non-adherence to the
payment schedule and policies may result in penalties and/or cancellation(s).
Name (Please Print): __________________________
Signature: __________________________________
Date: _________________________
Make checks payable to JCCAA/LLC:
Send with Registration Form, Liability Waiver Form and a photocopy of your passport to:
Wendy Lam 15922 Oak Island Dr., Tomball, TX 77377
The Travel Agency reserves the right to make any changes to the itinerary or price without notice due to any unforeseen event
including but not limited to natural disaster, war, strike, airline flight cancellation or airline itinerary changes.
J Joint Chinese College Alumni Association of Southern USA
美南中國大專院校聯合校友會
Liability Waiver Form
Event: JCCAA/LLC 2016 Discover the Spectacular Eastern Europe & Russia Trip
To the best of my knowledge, I am in good physical condition and fully able to participate in this event. I am fully
aware of the risks and hazards connected with the participation in this event, including physical injury or even
death, and herby elect to voluntarily participate in said event, knowing that the associated activity may be
hazardous to me and my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS
OR LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by
me, or loss or damage to property owned by me, as a result of participation in this course.
I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE, Joint Chinese College Alumni
Association of Southern USA, , their officers, servants, agents, and the event coordinators (hereinafter referred to
as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out
of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property
belonging to me, while participating in physical activity, or while on or upon the premises where the event is being
conducted.
It is my expressed intent that this release and hold harmless agreement shall bind the members of my family and
spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a
RELEASE, WAIVE, DISCHARGE, and CONVENTION TO SUE the above named RELEASEES. I hereby
further agree that this Waiver of Liability and Hold Harmless Agreement shall be constructed in accordance with
the laws of the State of Texas.
In signing this release, I acknowledge and represent that I HAVE READ THE FORGOING Waiver of Liability
and Hold Harmless Agreement, UNDERSTAND IT AND SIGN IT VOLUNTARILY as my own free act and
deed; no oral representations, statements or inducements, apart from the foregoing written agreements have been
made; and I EXECUTE THIS RELEASE FOR FULL, ADEQUATE AND COMPLETE CONSIDERATION
FULLY INTENDING TO BE BOUND BY SAME.
_________________________________
Signature
_________________________________
Print Name
_________________________________
Date
_________________________________
Event – JCCAA/LLC 2016 Eastern Europe & Russia Trip
_________________________________
Parent’s Signature (if under 18)
__________________________________
Parent’s Print Name
FOR REGISTRATION AND MORE INFORMATION, check jccaa.net or call:
Ray Liao (281)251-5663, Wendy Lam (281)370-9404, Aileen Don 281-980-0186 or email llc_trip@jccaa.org