Consent to Maintain and Use Personal Information

On January 1, 2004, the Government of Canada fully implemented the Personal Information Protection and Electronic Documents Act (PIPEDA). Accordingly, in order to be in compliance with the Act, UNIGLOBE The Premiere Travel Group is required to obtain consent from its customers in order to use the personal information provided to us. The personal information which we maintain and use is solely for the purposes of servicing the travel arrangements which you request incompliance with the rules and regulations of governments and travel industry suppliers.

This information is stored, secured, disclosed, and handled in strict accordance with PIPEDA and UNIGLOBE The Premiere Travel Group compliant Privacy Policy. Our complete policy is available on our web site: www.premieregroup.com/privacy, posted in our offices, and available anytime for your review and consideration. If you wish a copy sent to you via e-mail, fax, or mail please let us know.

CONSENT TO RELEASE INFO TO OTHER PARTIES

Please list the names below of any persons that you authorize to have access to your personal data.

Name: _________________________________
Name: _________________________________
Name: _________________________________
Name: _________________________________

CONSENT

Accordingly, I duly authorize UNIGLOBE The Premiere Travel Group to maintain, update, and use my personal information and to use in strict accordance with the Privacy Policy stated by UNIGLOBE The Premiere Travel Group.

Company: ______________________________________________________________________

Name: _______________________________ Signature: _________________________________

Date:_________________________________

S.v.p. contacter notre bureau si vous désirez ce document en français.