Credit Card Authorization

In order to prevent charge-backs, it is necessary for you to provide a completed credit card authorization form as shown below.

By signing this form, you authorize Karma Getaways to process the card number stated below for the agreed upon purchases. Your payment details will be submitted to our supplier to secure your booking and complete the transaction. This form must be completed for each Credit/Debit card used. This form is not required for travelers or customers choosing to pay cash.

All information will remain confidential.
Credit Card Authorization

Trip Acknowledgement Form
I authorize the following type of payment to be processed on my Credit/Debit card:

One-Time Charge (Full Payment)Monthly Recurring (Payment Plan)
Confirm Payment Type:*
- You have verified that all names are spelled correctly on your travel documents and that they are your legal names. Incorrectly spelled names may incur a charge to travelers when requesting changes.
- It is strongly recommended to purchase travel insurance. If you choose not to purchase travel or cancellation insurance, you understand you are liable for any cancellation penalties and out-of-pocket expenses incurred. You will also make your own provisions in the event of an emergency while traveling. The Trip Travel Insurance Premium is non-refundable.
INSURANCE

I ACCEPT and want to purchase travel insurance coverage. I understand the trip cancellations and interruption details, terms & conditions that were provided or discussed with me. (Travel Insurance is NOT free and pricing for insurance will be included your total price above. The price differs based on the customers needs and will be discussed on an individual basis).I am DECLINING and do not want to purchase travel insurance coverage. I understand that cancelling this trip without insurance does not guarantee or allow for any refunds unless a refund is outlined in writing. I acknowledge that all the information above is correct.
Please select ALL purchased items:

Purchaser Name:

First NameLast Name
Card Type:*
Confirm last 4 of Credit/Debit #:*
Confirm CVV #:*
Billing Address:*

Street Address

Unit, APT #

CityState

Zip Code
Please upload a government issued I.D. (front)*
By signing below, I am giving authorization to charge my card for all charges listed above. I have been informed of the cancellation policies for our travel services and have been made aware of the benefits of travel protection. I understand that the sole purpose for this authorization agreement is to serve as verifiable proof to my banking institution in cases of fraudulent chargebacks.
Cardholder's Signature

Clear
Should be Empty: