Please write your name using the cursor in the Electronic Signature field on the bottom of this form

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 understand change and cancellation policies. You also certify you reviewed the appropriate Travel Protection Plan details and understand that cancellation penalties may apply. You acknowledge that you have been offered to purchase trip cancellation/interruption insurance. You understand you may purchase travel insurance at a later date and before travel takes place, but in that event, the terms and conditions of your coverage may be more restricted. Insurance is not refundable. The charge for your reservation will be manually applied by the agency to your reservation. If there are any issues, your 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. You authorize the travel agency to use the above information to charge your credit card for the stated amount. Completion of this form and the initialing of this box signifies acceptance in lieu of your signature and authorizes your agent to apply future payments 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.