Group Leaders! Please Contact Your Xperitas Program Manager

GROUP LEADERS! PLEASE CONTACT YOUR XPERITAS PROGRAM MANAGER

BEFORE MAKING ALTERNATE TRAVEL PLANS.

Mail this form to Xperitas or email the form to . No arrangements can be made prior to receipt of this form. Xperitas does not guarantee that changes can be made to this reservation and changes are subject to airline rules and additional fees.

Before making family/companion flight arrangements, please speak with the Xperitas Air Manager. Group air contract restrictions may not allow your ticket to be changed to the same airline, date, route or flights as your private travel companions.

I am requesting the following change in either the outbound flight or the return flight – check one. Passengers must arrange their own transportation between cities abroad.

_____ Outbound flight Desired date of travel (include alternate dates)

Departure city Arrival City

OR _____ Return flight Desired date of travel (include alternate dates)

Departure City Arrival City

IMPORTANT: Xperitas will notify you of any additional airline charges that may apply before new flights are confirmed. Airline, dates, cities and schedules are subject to availability and airline group contract rules. All additional charges must be paid in full immediately or the alternate flights will be subject to cancellation.

Your name as it appears on your passport Date of Birth (MM/DD/YY)

School Destination Country

I understand that the separate flight must be accomplished without any liability on the part of Xperitas for any arrangements made or costs incurred. I understand there is a risk that the group air arrangements may change after alternate arrangements have been made and I may no longer be able to fly with the group or alternate flights will need to be made on a different airline. Insurance coverage is not active while I travel separate from the Xperitas group.

I have read the above information and agree to these stipulations. I release Xperitas from any and all responsibility during the time I am traveling separate from the group.

The Xperitas Program Manager, the other group leaders and the parents of my students are aware of my alternate travel plans and are in agreement with the following plans for an alternate adult chaperone: ______

______

Signature Date

Mailing Address

Daytime Phone Number Email Address

Xperitas 129 North 2nd St. #102, Minneapolis, MN 55401

Tel: 612.436.8299 • 800.892.0022 • Fax: 612.436.8298 • Email: • Web: