DAMAGE & TRAVEL INSURANCE Name(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Your Trip InformationArrival Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Departure Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Reservation ID(Required) Damage & Travel Insurance Vacation Rental Damage Insurance (Optional): Vacation Rental Damage Insurance is a cost of $70 per reservation and covers unintentional damages to the rental unit interior that occur during your stay, provided they are disclosed to management prior to check-out. If there are unreported damages discovered after you have departed, this insurance will be null and void may result in renter being subject to pay for such damages. It is the responsibility of the renter to examine and report the unit for any area of damage within 24 hours of arrival. The policy will pay a maximum benefit of $3000. Any damages that exceed $3000 will be charged to the credit card on file. If, during your stay at one of our Rental Properties, an Insured Person causes any damage to real or personal property of the unit as a result of inadvertent acts or omissions, the Insurer will reimburse the Insured for the cost of repair or replacement of such property up to a maximum benefit of $3000. Certain terms and conditions apply. Full details of the Vacation Rental Damage coverage are contained in the Certificate of Insurance or Insurance Policy View Policy. Refundable Security Deposit Hold (Mandatory Unless Vacation Rental Damage Insurance is Purchased): If you choose to not purchase the $70 damage insurance, there will be a $3000.00 refundable charge to your credit card for damages, charged upon arrival. After your departure, pending no damages, you will receive this Security Deposit Hold amount back in full to the credit card we have on file, approximately 10-15 business days. In the event that your credit card is inactive or has changed, we will then issue a check by mail. Generali Global Assistance (Formerly CSA Travel Protection) (Optional): Travel Protection Insurance can be purchased before the final payment comes due. By submitting payment for this plan, you authorize and request CSA Travel Protection and Insurance Services to pay directly North Captiva Island Club any amount payable under the terms and conditions of the Vacation Rental Damage. Please contact North Captiva Island Club directly if you wish to participate in this plan. Cost: 7.65% of Gross Rent and Tax CSA-Generali Travel Insurance Claims If you have a travel insurance plan from CSA Travel Protection or Generali Global Assistance, and have questions,contact them by clicking the link below: CSA- Generali Travel Insurance Phone: 800-541-3522 Monday – Friday: 6 a.m. – 6 p.m. PT PLAN DETAILS The plan cost includes the insurance premium and assistance services fee. Insurance coverages are underwritten by: Generali U.S. Branch, New York, NY; NAIC # 11231, for the operating name used in certain states, and other important information about the Insurance & Assistance Services Plan, please see Important Disclosures. See Plan details Choose A Damage Protection Plan:(Required)$70 Vacation Rental Damage Insurance (view link above for plan details)$3,000 Security DepositTravel InsuranceTravel Protection Plan(Required)YesNoTotal Trip Cost. Add Your Total Amount Here.Total amount with all fees includedHiddenSecond NumberTravel Insurance Cost Price: $0.00 Total Credit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name