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. Cancellation penalties may apply. Insurance is not refundable. PLEASE NOTE THAT IT IS REQUIRED THAT YOU FORWARD YOUR CREDIT CARD CVV NUMBER TO THE AGENCY IN A SEPARATE EMAIL. THIS IS FOR YOUR SECURITY AS WELL AS OUR PCI COMPLIANCE. I will not hold Intoxicating Travel Group LLC, responsible for airline delays, overbooked hotels or car rental agreement issues that are beyond the control of my travel agent. Intoxicating Travel Group, LLC has no special knowledge regarding the financial condition of the Suppliers, unsafe conditions, health hazards, weather hazards, or climate extremes at locations to which you may travel. For information concerning possible dangers at destinations, Intoxicating Travel Group, LLC recommends contacting the Travel Warnings Section of the U.S. State Department at (202) 647-5225 or www.travel.state.gov. For medical information, Intoxicating Travel Group LLC recommends contacting the Centers for Disease Control at (877) FYI-TRIP or www.cdc.gov/travel. I understand that I assume full and complete responsibility for checking and verifying any and all passport, visa, vaccination, or other entry requirements of your destination(s), and all conditions regarding health, safety, security, political stability, and labor or civil unrest at such destination(s). I hereby release Intoxicating Travel Group LLC from all claims arising out of any problem covered in this paragraph, and to submit all other claims against us within 30 days after the return of your trip. I agree that the courts in {Montgomery County} will be the exclusive jurisdiction for all claims brought by me or Intoxicating Travel Group, LLC, and I hereby submit to the personal jurisdiction of those courts. Should any of the above occur, I understand there may be cost associated with rebooking and working with the suppliers. 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. I authorize the travel agency to use the above information to charge my credit card the stated amount. Completion of this form and the initialing of this box signifies acceptance in lieu of my signature. By checking the box below and adding your signature, you indicate that the above amount is correct, you authorize the travel agency to charge your credit card for the specified amount, and you agree to the terms and conditions.