Rotary ITHF Japan & Korea Tour 2016

MAY 16th ~MAY 26th, 2016

*** TOUR APPLICATION ***

PLEASE PRINT CLEARLY AND COMPLETE ALL INFORMATION ON FORM

MAIL TO:J T B USA, Inc. FAX TO:1-808-979-0100

1555 Kapiolani Blvd., Suite 0105 Honolulu, Hawaii96814

Any questions on this tour, please call at 1-808-979-0115 or

** NAME ON FORM MUST MATCH THE NAME AS SHOWN ON VALID PASSPORT **

** PASSPORT MUST HAVE AT LEAST 6 MONTH-VALIDITY AT TIME OF DEPARTURE **

  1. ______MR., MS., MRS. ___ / ___ /___

Last NameFirst Name Middle Name (Please circle one). Date of Birth (MM/DD/YY)

______

Passport NumberExpiration Date (MM / DD / YY) Passport Issued Country

  1. ______MR., MS., MRS. ___ / ___ /___

Last NameFirst Name Middle Name (Please circle one). Date of Birth (MM/DD/YY)

______

Passport NumberExpiration Date (MM / DD / YY) Passport Issued Country

______

HOME STREET ADDRESS CITY STATE ZIP COUNTRY

______

Home Phone NumberWork Phone NumberEmail-Address______

Emergency Contact NameHome Phone NumberWork Phone Number

ITHF members and partners only.

If you wish to invite family or friends,

pleasecontact Steve & Noko Yoshida, .

ITHF member: yes( ). No ( )

- CUSTOMER’S ACKNOWLEDGEMENT -

I certify that I have read the Tour’s Terms and Conditions(Page 2) and agree to abide by them

Signature: ______Date: ______

TOUR DEPOSIT DUE: $300.00 PER PERSON. PLEASE ENCLOSE FORM OF PAYMENT WITH APPLICATION

Tour Deposit – Form of Payment:___ Check enclosed ___ Credit Card

Credit Card (circle one):MastercardVisa Amex Diners Discover JCB

Name of Credit Card holder:______

Credit Card Number:______Expiration Date ______

CV code (3 or 4 digit security code on back of credit card) ______Name of Issuing Bank ______

Card Holder’s Billing Address: ______

City ______State ______Zip (Required) ______Phone #______

Total amount $______Cardholder’s Signature: ______Date: ______Page 1

JTB USA, Inc TOUR’S TERMS & CONDITIONS

  1. Deposit and Final Payment:
  2. A $300.00 non-refundable deposit per person is required at the time of booking.
  3. The remaining balance is due by March 14th, 2016.
  4. In case of voluntary cancellation, the deposit remains non-refundable.
  5. Payment method:

Option1: Check (Please enclose a check along with application form)

Option2: Credit card (Please fill out credit card information on Page 1)

*an additional 3% transaction fee will apply for credit card payment each time

For example: $300 deposit + $9 (3% fee of $300) = Total charge $309.00

$2695 remaining balance + $80.85(3% fee of $2512) = Total charge $2775.85

*Remaining balance is just as an example

  1. Cancellation Fee: (Please read very carefully)
  2. Regardless of reason, cancellations result in costly charges from travel and hotel providers covering penalties and fees incurred by canceling confirmed bookings. Therefore, the following fees will apply.

* Before final payment (March 14th, 2016) $300deposit

* Between March 15th and April 4th, 2016 30% of the total tour fee

* Between April 5th and April 18th, 2016 50% of the total tour fee

* Between April 19thand May 9th, 2016 75% of the total tour fee

*On or after May 10th , 2016 100% of the total tour fee

*Any additional individual arrangements may not be refundable.

  1. Responsibility:

The tour participant agrees that neither JTB USA, Inc nor its affiliates shall be liable for any damage, loss (including personal injury, death, and property loss) or expense occasioned by any act or omission of any supplier providing services, or any insurer or insurance administrator under the Travel Protection Plan, or of any other person.

We strongly advise that tour participants purchase the Optional Travel Insurance plans.

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