University of Alabama Honors College University Fellows ExperienceExploring Cuba January 7 – 14, 2024 Cuba U of A 01/07/2024 Students Email Address Last Name as on passport First Name as on passport Middle Name as on passport Gender MaleFemale Date of Birth (format: daymonthyear–15OCT95) Passport Issue Date (format 15OCT25) Passport expiration date (format 15OCT25) Passport must be valid for 6 months beyond your travel end date Passport Number Passport Nationality / Country of Issue Please email a scan of your passport photo page to passport@conservancytravel.org (REQUIRED) I will submit a passport within 2 days Address First Name * First Last Name * Last Known As Name/Nickname Address * Address Street Address Street Address Building/Suite/Apartment # Building/Suite/Apartment # City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Mobile Phone Mobile Number above Valid as contact during travel Yes No Unknown Roommate: Yes or No Yes (Name below) No (Single Room) Single Supplement Applies Roommate Name(s) Each traveler must register and complete the Terms and Conditions Agreement individually Health/Medical/Physical Conditions or Disabilities (Please call us to discuss any notable health or medical conditions, to confirm this destination can accommodate your needs.) Dietary Restrictions Allergies CUBA TRAVEL AND TOUR AGREEMENT * Registration CUBA TRAVEL AND TOUR AGREEMENT This document creates a contractual relationship between The Center for Conservation and Community d/b/a Conservancy Travel (“Conservancy Travel” or “CT”) and its subsidiaries and you, the “Participant”. After reading this entire agreement (the “agreement”), for your travel package (“tour”, “journey”, “program” or “expedition”) reservation to be completed, you must indicate your acceptance of the terms and conditions found in this agreement by acknowledging: Package Includes: • Accommodations in privately owned B&Bs in Vinales and Havana • Expert private Cuban guides and vehicles as per itinerary • Affadavit of participation in a pre-planned, fully scheduled program of Support for the Cuban People travel to Cuba under the U.S. Department of the Treasury general license. • Entrance fees for included activities and visits as per the itinerary. • Meals as noted as included in the itinerary (B,L,D) 17 Total; 7 breakfasts, 6 lunches, 4 dinners. • 2 drinks per each included lunch and dinner (bottled water, soft drinks). • Potable water to refill your personal water bottle, while touring with the guide. • Comprehensive pre-departure packing and general Cuba information • Gratuities for included meals. • Gratuities for local specialty guides when required • Air transportation from USA-Cuba-USA • Cuban tourist visa, required for entry and departure Not Included in the Package • Meals not mentioned in the program as included • Optional activities, if any, that are not already included in the itinerary • Tips for accommodations housekeeping and live music during meals • Laundry or other expenses of a personal nature • Baggage handling and all baggage charges • End of tour gratuity for Cuban Guides and Drivers, recommended $20 per day for the guide; $10 per day for the driver Travel Documents/Vaccinations: Travel participants must be in possession of valid passports and any visas (if necessary for the destination). Any permits that may be required for the destination will be provided by Conservancy Travel. Information as to these matters and as to climate, clothing, baggage, gear, and similar matters is given in good faith but without responsibility on the part of Conservancy Travel. California Seller of Travel Program: Please be advised California has established a Travel Consumer Restitution Fund. It does not cover non-California residents, and even in the case of California residents, does not cover any foreign travel where the foreign “providers of transportation of travel services” are not in compliance with the seller of travel law (compliance being defined as: registered as a seller of travel in California and a participant in the Travel Consumer Restitution Fund). Thus, your tour does not qualify and by law you are required to be advised that you would not be eligible to make any claim from that fund in the unlikely event of default by Conservancy Travel, the airline or any of our foreign suppliers. Registration as a seller of travel does not constitute approval by the State of California. Limits on Conservancy Travel Responsibilities: Conservancy Travel and their affiliates, owners, officers, agents, employees, contractors, and subcontractors (hereafter in this paragraph “Conservancy Travel”) purchase transportation, hotel accommodations, restaurant services, and other services from various independent suppliers that are not subject to its control. Neither Conservancy Travel, nor any associate organization, agent, employee, contractor, or subcontractor shall be held liable for any act, default, injury (including death), loss, expense, damage, deviation, delay, curtailment, or inconvenience caused to or suffered by any person or their property, howsoever arising, which may occur or be incurred by any organization or person, even though such act, default, injury, loss, expense, damage, deviation, delay, curtailment or inconvenience may have been caused or contributed to: (a) by the act, neglect or default of Conservancy Travel, owners, officers, agents, employees, contractors, and subcontractors, or of any persons for whose acts it would otherwise be responsible, or (b) defects or failures of any aircraft, vessel, automotive vehicle or other equipment or instrumentality under the control of independent suppliers. In addition, Conservancy Travel will not be liable for delays in departure or interruption of your vacation arrangements caused by weather conditions, technical problems of any aircraft, vessel, automotive vehicle, or other equipment or instrumentality, strikes, war, terrorist activity, civil commotion, act of God, perils of the sea, harbors, rivers, or other navigable water, act of any governmental or ruling authority, epidemic, collision, stranding, fire, any abrupt or unexpected increase in the cost of fuel or shortage of fuel, or any other cause or circumstance beyond Conservancy Travel responsibility or control. The right is reserved to substitute accommodations or modes of transportation and to make any changes in the itinerary where deemed necessary or caused by changes in air schedules. On tours of this type, it is not possible to accommodate persons with severe health problems or physical disabilities. It is the participant’s, or guardian’s, responsibility to judge the appropriateness of these travel activities to his or her physical capabilities; however, Conservancy Travel reserves the right to require your physician’s permission for travel. Conservancy Travel takes no responsibility for special arrangements or problems incurred by participants physically unable to participate in the planned activities. No refund can be made for absence from the tour unless arrangements are made at the time of booking. The right is reserved to decline to accept or retain any person as a participant for any reason, which affects the operation of the tour or the rights and welfare or enjoyment of the other participants. Conservancy Travel will not discriminate against any individual because of race, sex, creed, or nationality. In no event will Conservancy Travel be responsible for incidental, consequential or special damage or loss suffered by any person. Conservancy Travel maximum liability, for any reason whatsoever, will be limited to the amount paid to Conservancy Travel for its services. In issuing tickets and coupons for transportation of the purchaser by any means and making arrangements for hotel or other accommodation, Conservancy Travel is not acting as principal but only as agent for the companies, corporations, or persons providing or offering the means of transportation and accommodation. To the extent Conservancy Travel shall not be acting as an agent, as stated above, it shall be deemed to be acting as an agent of the purchasers in arranging or booking transportation and accommodation. Arbitration: Any controversy or claim arising out of or relating to this Agreement or the performance there under, including without limitation any claim related to bodily injury, property damage, or death, shall be settled by binding arbitration in Birmingham, Alabama in accordance with the rules of the American Arbitration Association then existing, and judgment on the arbitration award may be entered in any court having jurisdiction over the subject matter of the controversy. This agreement to arbitrate does not waive or modify the liability release contained in this document. Waiver of Jury Trial: IN CONNECTION WITH ANY ACTION OR LEGAL PROCEEDING ARISING OUT OF THIS AGREEMENT, THE PARTIES HEREBY SPECIFICALLY AND KNOWINGLY WAIVE ANY RIGHTS THAT EITHER PARTY MIGHT HAVE TO DEMAND A JURY TRIAL. Exclusive Governing Law and Jurisdiction: THIS AGREEMENT AND ANY ACTIONS AND PROCEEDINGS BROUGHT HEREUNDER SHALL BE GOVERNED BY THE LAWS OF THE STATE OF ALABAMA, WITHOUT REGARD TO CONFLICTS OF LAWS PRINCIPLES. IF THE RIGHT TO SEEK ARBITRATION IS FOR ANY REASON WAIVED BY BOTH PARTIES, OR IF JUDICIAL REVIEW OF ANY ARBITRATION DECISION IS SOUGHT, ANY ACTION OR LEGAL PROCEEDING TO ENFORCE ANY PROVISION HEREOF, OR BASED ON ANY RIGHT ARISING OUT OF, THIS AGREEMENT SHALL BE BROUGHT EXCLUSIVELY IN THE COURTS OF THE STATE OF ALABAMA, OR, IF IT HAS OR CAN ACQUIRE JURISDICTION, IN THE UNITED STATES DISTRICT COURT FOR THE STATE OF ALABAMA, AND ALL OF THE PARTIES HERETO HEREBY CONSENT TO THE EXCLUSIVE JURISDICTION OF SUCH COURTS AND OF THE APPROPRIATE APPELLATE COURTS IN ANY SUCH ACTION OR LEGAL PROCEEDING AND WAIVE ANY OBJECTION TO VENUE OR JURISDICTION IN CONNECTION THEREWITH. Severability: The invalidity or unenforceability of any part of this Agreement, or the invalidity of its application to a specific situation or circumstance, shall not affect the validity of the remainder of this Agreement, or its application to other situations or circumstances. Any provision of this Agreement held invalid or unenforceable only in part or degree will remain in full force and effect to the extent not held invalid or unenforceable. Waiver: Any failure by either party at any time, or from time to time, to enforce or to require the strict keeping and performance of any of the terms or conditions of this Agreement shall not constitute a waiver of any such terms or conditions and shall not affect or impair such terms and conditions in any way or the right of such party at any time to avail itself of such remedies as it has for the breach or breaches of such terms and conditions. Exclusivity: Except as otherwise expressly provided to the contrary, the rights herein granted and this Agreement are for the benefit of the parties hereto. The terms and conditions of this Agreement shall be exclusive of any advertising, marketing, or other sales literature or activities of Conservancy Travel and nothing contained in any of such materials shall be construed to create any rights as a result of or in connection with this Agreement. Acknowledgment of Risk: You, or your legal guardian, understand and acknowledge that your travel in connection with and participation in the travel package arranged at your request by Conservancy Travel may involve risk and potential exposure to injury and possibly death. You also realize and acknowledge that risk and dangers may be caused by the negligence of the owners, directors, employees, contractors, subcontractors, officers, or agents of Conservancy Travel or the negligence or participation of other participants, contractors and/or subcontractors to Conservancy Travel. You also recognize and acknowledge that risk and dangers may arise from foreseeable and unforeseeable causes, including weather and other acts of nature. You fully understand and acknowledge that the aforementioned risks, dangers and hazards are a potential in connection with recreational activities which may take place during your journey. Express Assumption of Risk and Responsibility: In recognition of the inherent risk of the travels and related activities in which you are intending to engage, you, or your legal guardian, confirm that you are physically and mentally capable of participating in the activity, that you are willingly and knowingly electing to participate in this study tour in spite of the potential risk of danger, and you, or your legal guardian, willingly and voluntarily assume full responsibility for any injury, loss or damage suffered by you or caused by you, whether caused in whole or in part by the negligence of the owners, directors, agents, officers, employees, contractors, or subcontractors of Conservancy Travel. Release of Liability: In consideration of the services and arrangements provided by Conservancy Travel, you, or your legal guardian, for yourself and for your heirs, personal representatives or assigns, do hereby release, waive, discharge, hold harmless, and agree to indemnify Conservancy Travel, and its owners, officers, directors, agents, contractors, subcontractors, and employees from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services, lost profits, consequential, exemplary, indirect or punitive damages or otherwise which may arise out of or occur during your travel in connection with the scheduled travel package and any activities conducted in conjunction therewith. YOU, OR YOUR LEGAL GUARDIAN, SPECIFICALLY UNDERSTAND THAT YOU ARE RELEASING, DISCHARGING AND WAIVING ANY CLAIMS OR ACTIONS THAT YOU MAY HAVE PRESENTLY OR IN THE FUTURE FOR THE NEGLIGENT ACTS OR CONDUCT OF THE OWNERS, DIRECTORS, OFFICERS, EMPLOYEES, AGENTS, CONTRACTORS, OR SUBCONTRACTORS OF Conservancy Travel. Express waiver of any right to seek consequential, punitive or exemplary damages: Regardless of the situation or circumstances giving rise to a claim, you, or your legal guardian waive any right to seek consequential, punitive or exemplary damages against Conservancy Travel, their owners, officers, directors, agents, contractors, subcontractors, and employees, for any reason whatsoever. Time Limit for Claims: Conservancy Travel shall not be liable for claims, actions, or losses for bodily injury, emotional injury or distress, property damage, wrongful death, loss of services, lost profits, consequential, exemplary, indirect or punitive damages or otherwise which may arise out of or occur during your travel in connection with the expedition and any activities conducted in conjunction therewith, unless full details in writing are given to Conservancy Travel within 185 days after the date of the event giving rise to such claim. Suit to recover on any such claim shall not be maintainable unless filed within one (1) year after the date of the event giving rise to such claim and unless served on Conservancy Travel within 120 days after filing. You expressly waive all other potentially applicable state or federal limitation periods. Indemnity: You agree to indemnify, hold harmless, and defend Conservancy Travel against any damage, liability, suit, claim, penalty, fine, cost or expense whatsoever which arises out of your negligence or caused by your breach of these Terms and Conditions, or which results from your acts, omissions or defaults of any person acting on your behalf, or which results from the acts, omissions or defaults of, or any claims asserted by, the other participants on the expedition. Medical Care: In the event medical care becomes necessary on your journey, you may be hours or days travel by water, porter, animal, or other non-vehicular transportation from any medical facility. The medical facility you may be treated in may not have the same standards as hospitals or doctor’s offices in your home country. The medical personnel you will be treated by may not speak fluent English and have the same training as medical personnel in your home country. You further acknowledge that an emergency evacuation may be unavailable, expensive and delayed at your location, and that the medical facilities and attention available abroad may be limited. Decisions are made by Conservancy Travel staff based on a variety of perceptions and evaluations of the situation at hand. Participant understands and agrees to abide by these decisions. TSA Secure Flight: For airline tickets to be issued in conformity with the requirements of Secure Flight which has been mandated by the U.S. Department of Homeland Security’s Transportation Security Administration and implemented by the Transportation Security Administration (TSA), guests must provide their full name exactly as it appears on their government issued passport, date of birth, and gender when making airline reservations. If this information is incorrect, guests may experience delays or denial when trying to board an air carrier and may also be subject to penalties. To comply with this mandate, Conservancy Travel will require a copy of the picture page from the participants valid passport prior to issuing any tickets. Any penalties imposed upon the guest or Conservancy Travel resulting from incorrect information provided by the guest will be the sole responsibility of the guest. Likewise, any additional costs incurred due to delays or denial of travel resulting from incorrect information provided by the guest will also be the sole responsibility of the guest. The aforementioned mandated changes are set forth in the Secure Flight Final Rule, published in the Federal Register Volume 73, Number 209. To learn more visit www.tsa.gov/SecureFlight. Privacy Policy: Conservancy Travel Privacy Policy is incorporated into this agreement by reference and applies to you and your use of our website, other applications, platforms or channels, available now or created in the future, which are owned or operated by Conservancy Travel and through which we may make our programs and services available. In all your dealings with us you must ensure that others you represent are aware of the content of our Privacy Policy and consent to your acting on their behalf. In consideration of participating in my tour, my electronic acknowledgement, or that of my legal guardian, indicates that I have on the date shown, read and understood this document and I acknowledge that it affects my legal rights and agree to be bound by its terms. My e-acknowledgement also signifies my intention to relieve and indemnify Conservancy Travel, their owners, officers, directors, employees, agents, contractors, and subcontractors from any liability for personal injury, property damage or wrongful death which I might suffer during my participation in the scheduled journey. Participant has read and agree to the Tour Agreement (above). Yes If you are human, leave this field blank. Submit