Digitally sign & complete this form to complete make a payment on your booking. This form will authorize Travel Getaways by Connie to process a one time debit or credit card. Multiply charges may be processed for complex reservations using more than one supplier.

By signing this form you give permission to process payment from your account for the amount indicated on or after the indicated date.

Please note: Quoted prices are not guaranteed. Prices are subject to change until payment is processed.