EmailMeForm
QUICK PAYMENT & TERMS AGREEMENT
Name
*
First
Last
Phone
*
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Email
*
Trip Details: Destination / Cruise Ship / Cruise Port / Travel Dates:
*
(Which destination and approximate date)
If sharing a room, enter your roommate's name here.
PAYMENT INFORMATION:
Payment Type:
Deposit
Partial
Final
Service Fee
Amount Authorized:
*
$
Dollars
.
Cents
Credit Card
Card Number
Expiration
MM
/
YY
CVV
What is this?
3 or 4 digit number printed on the back/front of your credit card
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Data collected via fields that have our security seal are encrypted and stored with the highest global security standard — PCI compliance. Your data is absolutely safe in Vault.
Cardholder Name:
Billing ZIP:
TERMS:
Terms: I agree to the terms below
*
Authorization: By submitting this payment, I authorize Legna Travel to charge my card for the amount listed. I understand all payments are subject to supplier cancellation policies, which may be non-refundable. I acknowledge travel insurance has been offered and accept responsibility if declined. Legna Travel acts solely as an independent travel advisor and is not responsible for supplier changes, delays, or cancellations.
Full Name:
*
Signature
*
Clear
Date Time
*
MM
/
DD
/
YYYY