Credit Card Authorization Form

1
Today's Date* This field is required.
Date
Month
Day
Year
2
Card Holder Name* This field is required.Please enter your name as it appears on your card:
First Name
Middle Name
Last Name
Suffix
3
I Authorize Focus On Fun Travel To Charge Me For The Following:* This field is required.
Deposit
Regular Payment
Final Payment
Payment in Full
4
We use electronic documents to obtain consent and to notify you of important information regarding your transactions with us. Please check the box below to agree to electronic communications per our terms and conditions and privacy policies. Otherwise, please call us at 801.427.6506. I agree to Electronic Consent:* This field is required.
YESNO
5
By completing this form, I, the individual identified by "Cardholder Name" above, authorize the agent or agency providing this form on this website or by email, or their authorized representative, to charge my credit card for the travel related charges for this booking. I understand all the terms and conditions of this booking and agree to the terms and conditions provided to me for this travel arrangement, including all cancellation policies. I understand and agree that travel arrangements may be subject to non-refundable cancellation penalties. I agree to carefully read all emailed communication between and myself and note all restrictions that may apply. I further understand that as part of your travel services, you recommend that all travelers purchase some form of travel insurance to help protect their travel investment. I, the above-named Cardholder or authorized representative, certify that the information provided on this form is true and correct. I am authorized to effect charges on the credit card number provided. I agree that in the event of a discrepancy to my credit card account, I will notify your agency's accounting department within seven (7) business days of receiving the credit card statement or immediately upon knowledge of such error.* This field is required.
YESNO
6
Signature* This field is required.
7
Please verify that you are human* This field is required.
Should be Empty: