EmailMe Form - Individual Travel (Non Group

Individual Travel (Non Group - less than 10 rooms)

Website: www.BaylorTravelAgency.com
updated 02/2021
This is a ONE time credit/debit card authorization form. Please sign and complete this form to authorize Baylor Travel to make a payment on your behalf for your vacation indicated below. By signing this form you give us permission to debit your credit/debit card for the amount listed below. This is permission for a single transaction only, and does not provide authorization for any additional debits.

Image
Today's Date *
MM / DD / YYYY
Primary Traveler Information
Date of Birth *
MM / DD / YYYY
Salutation *
Full Name - As listed on your government issued identification (Passport (international travel) / (Drivers License (domestic travel) *
First Middle Last
The TSA requires that all airlines collect certain information from international and domestic travelers when making flight reservations. This information includes your full name as it appears on your passport or other government-issued identification, and which is printed onto your ticket and boarding passes. If the name on the travel documents does not match the identification you produce at the airport, you may be delayed and subject to extra security measures.
Primary Traveler Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Cell Phone *
### - ### - ####
Email Address *
I would like to add travel insurance for $89.00 per person. *
Please Add Additional Traveler(s) And Their Dates of Birth In The Notes Section Below.
Notes / Comments / Additional Travelers Info.
Destination *
Reason For Payment *
Initial Deposit
Final Payment
Vacation Installment Payment
Insurance / Other
Credit Card *

Card Number

Protected in vault 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.
Credit Card Billing Address (If Different Than Address Above)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Payment Amount *
Baylor Travel Terms and Conditions *
I agree to the following Terms & Conditions. In order to complete your transaction and confirm your travel arrangements, your submission of this authorization form is required. Charges are payable to the hotel, resort, tour operator, cruise line or other travel suppliers designated by Baylor Travel.
Baylor Travel Cancellation Fees *
Baylor Travel will charge a $100 cancellation fee per person in the event of a cancellation, unless stated differently in another forum. The fee can be paid via Paypal Invoice or Zelle. The cancellation fee must be paid prior to Baylor Travel submitting a cancellation request to the travel supplier. The travel supplier may charge a separate cancellation fee.
Payment Authorization via credit card / debit card listed above. *
I certify that I am authorized to make charges using this credit card / debit card. I agree to refrain from disputing any payment(s) with my credit card company or bank as long as the transaction corresponds with the terms indicated above. This payment authorization is for the goods and services described above. By submission of this form, I give authorization to Baylor Travel, an Independent Travel Agent for Cruises and Tours Unlimited and the travel vendor being used to debit my credit card / debit card for amount listed above.
Signature *
Clear