Contact Information
Who is your Travel Agent?
*
Please Select
Cathy Jackson
Kim Wohanka
Your Confirmation Number
*
:
Please use your confirmation number found on your invoice.
Your Name(s)
*
:
Your Email
*
:
Phone Number
*
Credit Card Type
*
:
Credit Card Type
Cash
American Express
MasterCard
Discover
Visa
Payment Type
*
:
Payment Type
Deposit
Other OR Final Payment
Travel Protection
*
:
ACCEPT Protection.
DECLINE Protection.
Additional Comments :
By submitting this payment authorization form, you certify and agree to the following: 1) You are the cardholder and authorize the travel agency or its chosen Tour Operator/Supplier/Cruise Line to charge the stated amount to the credit/debit card; 2) You agree not to submit a credit card chargeback with your credit card company. 3) You have verified that all information in the confirmation you received is accurate and no changes are required. 4) You have read and agree to the Terms & Conditions for your trip, have been offered Travel Protection, and understand that Travel Protection is non-refundable. 5) By clicking SUBMIT you consent to receiving important SMS messages about your reservation. Messages and Data rates may apply. Message frequency will vary. Reply Help to get more assistance. Reply Stop to Opt-out of messaging. 6) No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. This information will not be shared with any third parties. Once your payment form has been submitted, our agency will manually apply the payment to your reservation. If there are any issues, an agent will get back to you. Please note that your credit card statement will show the name of our supplier rather than the agency. Completion of this form indicates my approval of these terms.
I Agree
*
×
Ok
×
Uh oh!
An unexpected error has occured. Please enter all data for your credit card!
Retry