Trip Cancellation Insurance Waiver Form

(CONFIDENTIAL) - Please fill out and hit "SUBMIT" at bottom of form

It is the policy of Spears Travel to recommend travel insurance to all of our clients.  Although many people do not feel that travel insurance is important, we feel it is a mandatory ingredient to a worry-free vacation.

Please select one of the following: (Choice of 4)

 I have purchased insurance directly with Spears Travel

 I have purchased insurance online at

Policy # 

 I acknowledge receiving information about trip cancellation insurance from Spears Travel and herby declare by acknowledgement (submit) of this form that I declined at this time to purchase the optional insurance.


Contact Form

First name  

Last Name 


Phone Number ​​

Trip Departure Date 

Name of Travel Consultant (if known) Date 



By clicking "Submit" you agree you have read this form in its entirety.


You may also print and sign and return to: 
Spears Travel/Travel Leaders
P.O. Box 1256
Bartlesville, OK 74005
Fax 918-337-3630

Book Online





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