Group Travel | Passenger Emergency Information Form

Group Travel Passenger Emergency Information

The Passenger Emergency Information form is for AAA Group Tour travelers. Submit this form by seven days before your Group departure. Thank you!

Emergency Contact Information

Medications

Medicine Name Strength Dosage Frequency Time Taken
more items
 
List any that would be important if medical care is needed, ex: Penicillin, Bee stings.
List anything that may be critical in an emergency situation (Ex: Heart Condition, Pacemaker, Diabetes, Seizures, Artificial Parts)

Permission

I give AAA WCNY representatives permission to use this information in case of emergency and for them to provide the information to medical or law enforcement personnel as needed. I also give permission for a AAA WCNY representative to collect my belongings if necessary and absolve him/her of responsibility for any loss incurred.
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You will see a Thank You message on-screen as well as a confirmation email from AAA when this form is successfully submitted.