Matta Trip Forms: Lucca 2022 COMPLETE the Traveler Survey and Terms/Waivers below: Traveler Survey Form for Lucca Trip 1Travel Details2Participant Survey3Terms & Waivers Name* First Last Cell Phone/Contact Number while traveling*Email* Enter Email Confirm Email Emergency Contact Number*Flight InformationAt trip reservation time you may not have this info, so please make a note to send it to me after booking flightsAirline Flight NumberHotel InformationRoom Selection* Double Occupancy Single Occupancy Name of Roomate(if sharing a room) Do you follow: (Check all that apply) Studentessa Matta Blog Facebook Page Twitter Account Where did you hear about the Studentessa Matta Immersion Trip? What is your Italian Language proficiency? Beginner (can’t wait to learn!) Intermediate (good grasp of grammar & vocab) Advanced Is this your first time to Italy? Yes No How many times have you traveled in Italy?Please enter a number from 1 to 25.Age* 20-35 36-46 47-57 58-68 69-79 Indicate your Level of Physical Activity Very Active & Physically Fit, Sure Would Love to Do Yoga!, Big Walker, Can Swim Problems Walking, Fatigues Easily, Can’t Climb Stairs, Can’t Swim Dietary Preferences/Concerns (check all that apply) Vegetarian Can’t Eat Wheat Can’t Eat Dairy – Hold the Mozarella Shell Fish Allergy Nut Allergy Tomatoes give me indigestion Specific Food Allergies Special NeedsOther than being crazy about Italy and the Language, please explain. i.e., medical concerns, takes medication, requires larger bed. In case of existing medical condition please indicate that you have consulted your physician prior to trip participation.I enjoy wine and wouldn’t be opposed to drinking a Spritz Yes No Indicate if you are a Smoker / Non Smoker Non Smoker Smoker Trip Arrangements*Studentessa Matta Travel Philosophy: My Language and Cultural Immersion tours are designed to give participants the chance to experience Italy as I do. I like to converse in Italian (with anyone who will give me the time of day), explore new areas, make new friends, meet up with old friends, get off the beaten track, try new foods, enjoy the art & architecture and simply relish every moment I am in Italy. I participate in language classes and I am often discovering new things about Italy right along with you. I take thousands of photos and I love to share them with the world. I believe in being flexible & going with the flow. As a seasoned traveler, I realize that there can be bumps along the road (i.e. jet lag crankiness, transport strikes, closed shops, sore feet, miscommunication, wrong turns, getting lost, waiting, bad weather & cultural idiosyncrasies). Instead of focusing on a few inconveniences that might occur from time to time, I prefer to keep things positive and look for ways to turn bumps in the road to launching points for new experiences. I believe it is precisely these unexpected things that make traveling fun and even if you are stuck in a train station for an extra hour – YOU ARE IN ITALY & you can always find someone with whom you can practice your Italian and have a conversation! Therefore I ask all my travelers to make sure that along with their sensible walking shoes, they also pack a sense of humor. With a good attitude and spirit of adventure all things are possible; everyone has great experience and learning Italian, getting to know the locals and visiting Italy is so rewarding. If you agree…ANDIAMO! Participants have familiarized themselves with trip activities and are fully aware of the type of accommodations/beds/baths they will enjoy in Italy. They agree to the meal arrangements & realize that most, but not all meals are included in the total trip price & they will be responsible for some meals on free days. I have read trip itinerary, trip philosophy & I approve the accommodations and meal arrangements. I can’t wait to go to Italy with Melissa! Payment Agreement* If I paid the Deposit to reserve my spot, I agree to pay the Final Payment which is due 60 days before trip begins. (If I paid in full at the time of reservation, I understand no further payment is required.) Photo Waiver* I give permission to Melissa to use photos of me taken during the Studentessamatta immersion in the Studentessa Matta blog, Studentessa Matta Facebook Page and @ItaliaMelissa Twitter Feed, as long as she follows the girlfriend’s code & guarantees that the photos are flattering & will be ones that my mother would enjoy. Waiver of Responsibility* I agree that Melissa Muldoon, aka la Studentessa Matta, and her Italian Partners, are not responsible and will not be held responsible for any personal injury, theft, loss of property/luggage/passport, auto accidents, delays in travel, transport strikes, health related problems or natural disasters during the Matta Italian Language & Immersion Trip. Melissa & her partners will strive to adhere to the program itinerary as published, but please be advised that it may be necessary to substitute an activity due to events beyond our control or because of any physical limitations of individual members in the group. Language lessons are provided, but the progress and the retention of the material is the learner’s responsibility based on the amount of effort & dedication exerted by each individual. We provide language support, lessons and opportunities to use & practice the language during the immersion trip and it is each participant’s responsibility to make the most of the experience if he wishes to improve his language skills. Signature* (Type your full name here. This will serve as your electronic signature.)