• Credit Card Authorization Form

    emilyl@goldgellgetways.com * www.goldgellgetaways.com
  • Please note that your payment will not be processed until we receive your info, and enter it directly into a supplier's booking portal. We will then send you an email confirmation.

  • Credit Card Type*
  • Payment Type*
  • Format: (000) 000-0000.
  • I hereby authorize Emily Lenihan with Goldgell Getaways or the travel supplier that my booking is through to charge my credit card for travel reservation and confirm that the information for the credit card and billing address is complete and accurate.

  • PLEASE SELECT WHICH APPLIES AND SIGN BELOW ONLY IF YOU ARE SUBMITTING YOUR FINAL PAYMENT
  • Should be Empty: