NAME OF TRIP:                                                     closing date:

 


To:                                                                  Location:

 (Trip organiser)

for flying trips, the names as shown on this application should correspond to those shown in your passport(s)

Name

HASSRA member

Yes/No

Insurance required

Yes/No

Type of Room

Double/Twin/Single/

Family

D/T/S/F

Amount of Deposit + Insurance submitted

Balance of cost of Trip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

 

 

Do you have any special dietary or ability requirements?

 


Name of lead contact:

 


Address (Work or Home)

 

Phone                                                                     Mobile

 


E-mail

Please ensure that you provide full contact details.  Failure may prejudice your booking.

 

If travelling alone, would you like to "buddy" in a twin room with another tripper of the same sex, to avoid the single supplement?       YES / NO

 

Would you be willing to "buddy" if you have requested a single room but none is available? YES /NO

 
Details of Insurance cover already held  (** essential for foreign trips)

 

Insurer                                                  Policy No                                                            Expiry date___/__  /__ 

 

Please refer to the trip advertisement for:

§         The names and address of the trip organiser, to whom this form should be sent 

§         The closing date for applications

§         The deposit required

§         The date on which the balance of payment will be due

 

Cheques should be made payable to HASSRA Leeds unless otherwise specified in the advertisement. In the event of over-subscription, a ballot will be held and uncashed cheques will be returned to unsuccessful applicants.

 

·         Remember to enclose your cheque with the application.  Cheques will not be banked until after the closing date, but bookings will not be accepted without a completed application together with cheque.

·         Insurance is essential for trips abroad.  This should include cover for medical treatment, an emergency helpline, and repatriation cover – see also para 5 of the terms and conditions. For activities such as mountain sports, specialist insurance will be necessary.

 

Applicants requiring confirmation that booking form & cheque has been received must enclose a self addressed envelope/grid.

 

Please refer to full terms and conditions when applying as printed in the Newsletter and on HASSRA Leeds website www.hassra-leeds.org