Before we make arrangements for your flight, hotel, car rental, tour, cruise, or other trip, we require that you sign this form; your signature will signify your agreement to read all tickets and documents and your agreement with the following terms and conditions:

            KTA, Inc. (“Brazos Country Travel”) acts as a sales agent for any airline, hotel, car-rental company, tour operator, cruise line, or other service provider named in your itinerary (“Suppliers”).  Brazos Country Travel is not responsible for acts or omissions of the Suppliers or their failure to provide services or adhere to their own schedules.

            Brazos Country Travel assumes no responsibility for and shall not be liable for any refund, personal injury, property damage, or other loss, accident, delay, inconvenience, or irregularity which may be caused by: (1) any defaults, wrongful or negligent acts, or omissions of the Suppliers; (2) any defect in or failure of any vehicle, craft, equipment, or instrumentality owned, operated, or otherwise used or provided by the Suppliers; or (3) any wrongful or negligent acts or omissions on the part of any other party not under Brazos Country Travel’s control.  You hereby release Brazos Country Travel from all claims arising out of anything covered by this paragraph.

            Brazos Country Travel has no special knowledge regarding the financial condition of the Suppliers, unsafe conditions, health hazards, weather hazards, or climate extremes at locations to which you may travel.  For information concerning possible dangers at destinations, Brazos Country Travel recommends contacting the Travel Warnings Section of the U.S. State Department at (202) 647-5225 or www.travel.state.gov.  For medical information, ABC recommends contacting the Centers for Disease Control at (877) FYI-TRIP or www.cdc.gov/travel.  You assume full and complete responsibility for checking and verifying any and all passport, visa, vaccination, or other entry requirements of your destination(s), and all conditions regarding health, safety, security, political stability, and labor or civil unrest at such destination(s).  You hereby release Brazos Country Travel from all claims arising out of anything covered by this paragraph. You agree that the courts in Washington County will be the exclusive jurisdiction for all claims brought by you or Brazos Country Travel, and you hereby submit to the personal jurisdiction of those courts.

            For your protection in the unlikely event of illness, we strongly recommend that you purchase trip cancellation insurance.  Please check the appropriate box below.  In order to further protect your travel investment, we also strongly recommend that you use a credit card for your purchase so that you can exercise your rights under the Fair Credit Billing Act if you do not receive the services you purchased.

EVERY TRAVELER OVER AGE 18 MUST SIGN A COPY OF THIS FORM

I do do not want to purchase Trip Cancellation Insurance.

Signature:           

Print Name:     Date:

E-Mail Address:    Year of Birth:

If you plan to submit this form by fax, please print, fill out, sign, fax to 979-530-9531.
If you plan to submit this form on the Internet, fill out completely and type your name in the Signature box, thus indicating your acceptance of all terms and conditions in the Agreement as if you had signed the document.