CC Authorization Form

TRAVEL PURCHASE AUTHORIZATION For Non-Website (Inteletravel.com) Purchases. Thank you for your purchase. InteleTravel.com & Enlightened Escapes, LLC, is pleased to confirm the following travel arrangements to complete your transaction and confirm your arrangements, your signature on this authorization is required. This form is NOT required for electronic purchases you complete yourself on our website, www.Inteletravel.com, https//:enlightenedescapes.inteletravel.com or its affiliates. Charges are payable ONLY to Inteletravel.com or the hotel, resort, tour operator, cruise line, or other travel supplier. Independent Travel Agents may not accept & process charges through any other account or accept checks, cash or other forms of payment.

TRAVEL INSURANCE WAIVER For your protection, Travel Insurance is strongly recommended & available upon request from Inteletravel.com. You can enroll for travel protection for Medical Expenses, Baggage Delays/Loss, Trip Delay or Cancellation, & other coverage or your Inteletravel.com Independent Travel Advisor can arrange coverage for you. For an online insurance quote and purchase, go to www.Inteletravel.com and click on Insure It.

To decline recommended travel insurance, your signature on this insurance waiver form is required. Final travel documents (tickets, vouchers, etc.) cannot be sent to you prior to receipt of the signed insurance waiver.

Client Name*

First NameLast Name

Email:*

example@example.com

Phone Number*

Format: (000) 000-0000.

I authorize Inteletravel.com, this supplier and/or Enlightened Escapes, LLC to charge my credit card for the authorized amount below.*

YesNo

Billing Address:*

Street Address

Street Address Line 2

CityState

Zip Code

Additional Traveler's Names (As Entered on Passport) & DOB + Rooming Assignment

ex: Room 1: Octavia LastName 01/01/1991, Nate LastName 11/1/1991 Room 2: Jane Doe 2/2/1992, John Doe 2/22/1992

Credit Card Information*

CC AUTHORIZATION

THIS PRODUCT IMPLEMENTED FOR CC INFORMATION ONLY

$ Free Quantity

Total

$0.00

Credit Card

PLEASE CHECK WHICH APPLIES AND SIGN BELOW

I have ACCEPTED & authorized the travel purchases, including travel insurance, & I am aware the insurance premium is not refundable which will be added on AFTER my deposit is locked in.

Signature

Date

OR

I have ACCEPTED and authorized the travel purchases above, and I understand that by signing below, I am DECLINING TRAVEL INSURANCE. I have read and understand all cancellation charges and change fees related to the above travel arrangements, and that I may not be entitled to a full refund should my travel plans change. In case of cancellation of nonrefundable airline tickets or other arrangements, I agree to pay all applicable penalties according to the travel supplier's rules.

Signature

Date

Accept or Decline*

AcceptDecline