Your Confirmation Number:
Please use your confirmation number,
the invoice number.
Your Name(s) *:
Your Email *:
Is this a Honeymoon Registry Gift?
If so, please provide the couple's name(s):
Credit Card Type *:
Credit Card Type
Payment Type *:
Other OR Final Payment
Honeymoon Registry Gift
Credit Card Security Code * :
Travel Protection *:
I understand that I CANNOT purchase the cancel for any reason insurance once my deposit is paid.
Additional Comments :
By submitting, you certify that you are the cardholder and are authorizing the travel agency or its chosen Tour Operator/Supplier/Cruise Line to charge the listed amount to the credit card. You certify that you have verified that all information contained in the confirmation you received is accurate. You also certify you have read the Terms & Conditions and the appropriate Travel Protection Plan details. Change and Cancellation penalties may apply. Insurance is not refundable. This charge will be manually applied by the agency to your reservation. If there are any issues, an agent will get back to you. Please note that you may not see a charge from the travel agency on your credit card statement; the charge will come from our supplier and/or the airline directly. Payment may take 3-5 business days to fully process and be reflected on your statement. IMPORTANT - Please click on this link to review important terms and conditions regarding travel arranged by Island Jack's Travel. www.islandjacks.com/terms--conditions.html
I authorize the agent of Island Jack's Travel to use the above information to charge my credit card the stated amount and signify that I have viewed, understand and accept the outlined Terms & Conditions above. Completion of this form and the initialing of this box signifies acceptance of payment and terms & conditions in lieu of my signature. Change and Cancellation penalties may apply. Insurance is not refundable.
Electronic Signature: (Sign with mouse or touch)*