Changes on the fly can be done to a certain extent. You can always choose to skip a meal or a sight, or swap for a totally different sight altogether. Alterations of itinerary that imply hotel changes are subject to rooms availability. Also, please note that in the case of last minute hotel cancellations, sometimes the hotel may charge late-cancellation penalties which can be up to 100% of the reservation cost. Additional costs generated by on-the-fly changes will be billed separately.
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