GO Travel Protection - Registration

Group Travel Insurance
for Group Organizers

User Account Registration Form
_______________________________________________

As a subscriber to Leisure Group Travel magazine or InSite newsletter, or as a member of the GO association,
you are pre-qualified to use our travel insurance program designed for busy Group Organizers like you.

All insurance bookings are done using your User Account on the GO Travel Protection website.

Complete this one-page Registration Form to obtain a User ID and Password for your User Account.
We will send you an email containing your User ID and Password.
Please allow 2 business days to process your Registration Form.

Group Organizer Information

Group Organizer Name:
Agency ID#:	PTM
Address:
City:
State:
Zip:
Contact Person:
Daytime Phone #:
Email Address:
Fax #:	(if none, enter "n/a")
Today's Date:
	By submitting this Registration Form, I certify that I am a subscriber to Leisure Group Travel Magazine, InSite Newsletter, or a member of the GO association.