Credit Authorization Form

Payment Authorization

Implied consent to utilize Credit or Debit Card for Vacation Expenses
My Agent's Name*
My Agent's Email*
example@wishesfamilytravel.com
Please note that the person completing this form must be the same as the name on the card.
Lead Guest Name: Exactly as on the Credit Card*

PrefixFirst NameMiddle NameLast Name
Phone Number*

Area CodePhone Number
I will be providing my Agent with the following Card Type:*

VISAMASTER CARDAmerican ExpressDiscover
Billing Address Associated with this Card*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Confirmation Number(s) or Travel Description
Authorization: I give Wishes Family Travel permission to use my credit card to make payments on my behalf for my personal vacation experience referenced on this form. I understand that said payments will go directly to the supplier, not to Wishes Family Travel. I understand that my Agent will contact me to obtain the security code for the card and the full card number I am submitting.

I attest that am an authorized user of the credit card I am submitting.

I attest to the fact that I am aware of all terms, conditions and cancelation policies regarding my vacation expeirence plans.
Travel Destination*
Travel Dates associated with this payment authorization*
Arrival Date*

DayMonthYear
Departure Date*

DayMonthYear
Wishes Family Travel Recommends
- All travelers should obtain passports if traveling outside of the US, including children
- All passengers should purchase Travel Insurance
- All guests should review their confirmation for accuracy and cancellation policies prior to depositing. Only the passenger will be able to recognize if there is an error on names and birth dates.
- WFT is not a seller of insurance and can only provide broad insurance coverage information. Guests interested in purchasing travel insurance should read the insurance policy provided by the travel supplier.
- Only the travelers are permitted to complete the online cruise check-in, cruise contract signatures, or print air boarding passes
Wishes Family Travel Terms and Conditions
Comments?
Date Completed this Form*

MonthDayYear
Date
Please Sign *

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Payment Authorization