Credit Card Authorization Form & Travel Insurance Waiver

TRAVEL PURCHASE AUTHORIZATION For Non-Website Purchases

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. Charges are payable ONLY to the agency or the hotel, resort, tour operator, cruise line or other travel supplier. Independent Travel Agents may not accept and 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 and available upon request from this agency. You can enroll for travel protection for Medical Expenses, Baggage Delays/Loss, Trip Delay or Cancellation, and other coverage. This agency can arrange coverage for you. For an insurance quote and purchase, please contact your travel agent.

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*

PrefixFirst NameLast NameSuffix

Booking or Quote number

Email*

example@example.com

Current Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number*

Please enter a valid phone number.

Charge Authorization*

I have ACCEPTED and authorize the travel purchases.

Travel Insurance (Select One)*

I have ACCEPTED and authorized the cost of travel insurance, and I am aware theinsurance premium is not refundable.I am DECLINING TRAVEL INSURANCE. I have read and understand all cancellationcharges and change fees related to my travel arrangements, and that I may not beentitled to a full refund should my travel plans change. In case of cancellation ofnonrefundable arrangements, I agree to pay all applicable penalties according to thetravel supplier’s rules.

Please select payment type (Select One)*

Pay in full the amount belowPay deposit amount below and balance to be paid in full by due date

Total Amount Authorized in USD*

Please provide the last four digits of the credit card you authorize us to charge (For your protection, we will collect the full number from you over the phone).*

I hereby authorize Jet Set With Joe,LLC or the travel supplier that my booking is valid to charge my credit card for travel reservation and confirm that the information for the credit card and billing address is complete and accurate.

Signature*