EmailMe Form - Credit Card Authorization

Name as it appears on credit card *
First Last
Billing Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region
Email *
Phone *
### - ### - ####
Credit Card

Card Number

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Acknowledged and accepted *
I/we hereby authorize the above transaction and guarantee and warrant that I am the legal cardholder of this credit card
Acknowledged and accepted *
I /we acknowledge that Transportation Security Administration prohibits certain hazardous materials in my checked luggage, carry on and on my person. I acknowledge that the list of prohibited items can be found on www.tsa.gov
Acknowledged and accepted *
I/we am aware that traveling outside of the United States requires a U. S. Passport. I am also aware TSA and/or Homeland Security require there be 6 month validity remaining on ALL passports from the RETURN date of trip
Acknowledged and accepted *
I /we acknowledge and accept the quote for travel and/or services provided to me by The Point of Travel and authorize the The Point of Travel to use the credit card information provided on my behalf for travel and/or services quoted and agreed upon.
Acknowledged and accepted *
I/we are aware of the cancellation policies and terms and conditions. I acknowledge and accept that I cannot dispute or attempt to chargeback any of the acknowledged and agreed upon charges based on my completion and signature on this form.
Acknowledged and accepted *
I/we are aware and are in agreement with all cancellation policies along with any and all terms and conditions suppliers used for my trip
New DOT Consumer Airline Protection Rules
(effective 2/26/2012) *
I/we understand that the airline tickets or air tours I am purchasing are subject to supplemental price increases that may be imposed after the date of purchase. Post-purchase price increases may be applied due to additional costs imposed by a supplier or government. I acknowledge that I may be charged additional sums by The Point of Travel to offset increased fees, fuel surcharges, taxes, fluctuation in foreign exchange markets or any combination thereof. I hereby consent to any post-purchase price increases and authorize The Point of Travel to charge my credit card for such additional amounts.
Signature *
Clear