Reservation Cancellation Form
Life happens and sometimes travel plans must be cancelled. Island Jack's Travel charges a small fee ($50.00 per adult capping at $100.00 per reservation) to pay for your agent's time and expenses incurred while servicing your account. The cancellation fee for a Contracted Group is $500.00 in addition to any penalties from the hotel/tour operator. You are given the opportunity to re-use the cancellation fees towards the final payment of a new trip if BOOKED (travel at any time) within 3 months of cancellation date!
Name as it appears on credit card
Your Reservation Number
Cancel Fee Authorization
One Adult - $50.00 Cancel Fee
Two or more Adults in same room- $100.00 Cancel Fee
Contracted Group Cancellation - $500.00 Cancel Fee
If only one person is cancelling check the $50.00 box. If the whole reservation (two or more adults) are cancelling check $100.00 box. If you are canceling a group or destination wedding check the $500.00 box. This fee will be applicable to the final payment of future travel if booked within 3 months of this cancellation. *I understand this fee is nonrefundable.
Name (s) of Cancelled Guest (s) or Group Name
Please specify the name or names of the individuals cancelling so we can cancel the correct person or persons. If a whole group is canceling, please give the group name or specifics (hotel/cruise and dates) so we can cancel the correct group.
Credit Card Type
American Express Credit Card
Visa Credit Card
Mastercard Credit Card
Discover Credit Card
Credit Card Number
- 3 digits on back of Visa/Mastercard/Discover OR
- 4 digits on front of American Express)
I agree to pay Cancellation Fee
By submitting, you certify that you are the cardholder and are authorizing Island Jack's Travel (affiliate of Nexion LLC) to charge $50.00 per adult (capped at $100.00 per reservation) OR $500.00 for complete group cancellation (5 or more rooms booked together) to this credit card for complete cancellation as requested.
This charge will be manually applied by the agency. No cancellation will be made until cancellation fee has been applied. It is important to cancel as early as possible to avoid additional fees. If there are any issues, an agent will get back to you. Please note that any refunds available from the reservation will be requested immediately. Refunds may take up to 15 business days to see on your statement.
I authorize the agent of Island Jack's Travel to to charge my credit card in the amount stated and signify that I have viewed, understand and accept the outlined Terms & Conditions above. Completion of this form and my signature below signifies acceptance of payment and terms & conditions. No chargebacks accepted. *I understand this fee is nonrefundable.
IMPORTANT: This Fee can be used towards the final payment of a new individual or group reservation if made within SIX MONTHS (can travel at any time) of this cancellation request. This fee will be applicable to the final payment of future travel if booked within 6 months of this cancellation.
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Trinidad and Tobago
Bosnia and Herzegovina
United Arab Emirates
Papua New Guinea
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Sao Tome and Principe
United Republic of Tanzania
Country / Region