EmailMe Form - * CREDIT CARD AUTHORIZATION FORM

* CREDIT CARD AUTHORIZATION FORM

Please note that third party payments will not be accepted. The credit card holder must be one of the listed travelers. (some exceptions may apply, IE: honeymoon gift from parent to child)

*Please note that if you choose to pay for your trip in installments, it is best to pay monthly so you do not run the risk of losing your deposit. Final Payment dates are provided by the Supplier (IE: Carnival, Funjet, Disney, etc) and extensions are not allowed.

All information will remain confidential. All fields are required.
IMPORTANT - Please note: Complete and accurate information is required to process this transaction. All information must be correct. If we are not able to process a payment because of incorrect information, loss of your vacation pricing and/or cancellation of an existing reservation may result.

**If female, I am not nor will be more than 24 weeks pregnant at time of travel** Per cruise and airline policies travel after 24 weeks is not authorized.**

PLEASE DOUBLE CHECK YOUR INFORMATION - FOR BOTH OF US! We want you to enjoy your vacation!

Agent Name: Lisa Goldbard Fuquay
Agent ID#20031875

CLIENTS FULL NAME *
First Middle Last
ADDITIONAL TRAVELERS FULL NAMES AS THEY ARE ON THEIR ID, IF NO ADDITIONAL PLEASE TYPE NA *
Email *

Confirm email
*

Full Name - as it appears on credit card to be used in this transaction:
Client/Credit Card Billing Address - make sure the address is correct - transaction will fail if the address is not the same as the billing address. *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone
### - ### - ####
TYPE OF CREDIT CARD TO BE USED IN THIS TRANSACTION

Credit Card Type

Please choose Credit Card
Credit Card *

Card Number

Please type your credit card number in exactly as on your credit card. Failure to do so may result in GREAT FUN VACATIONS being unable to obtain your booking and loss of quoted price.

Information is SSL secured

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.
Amount to be charged *
$ Dollars . Cents
Any Comments regarding the dollar amount to be charged in this transaction:
You can also instruct for payment options, such as X $ amount down and X$ amount per month on X date of the month.
Select a payment Option *
Travel Protection: *
I have accepted the quote given to me by GREAT FUN VACATIONS and authorize GREAT FUN VACATIONS to use said credit card on my behalf for services quoted and accepted. I understand this is a disclosure of business practices and permissive payment agreement for the purchase of travel services. I agree that payment may be made directly to selected travel suppliers on my behalf by GREAT FUN VACATIONS; paid in prorated amounts not to exceed the sum total of approved charges. I understand Debit Cards often impose "Daily Charge Limits" and multiple payments may be needed to complete the full balance due. I am aware of any potential Cancellation, Refund and Surcharge Policies and Fees by suppliers and agree not to dispute or chargeback any of the below signed for and acknowledged charges without proper course of action. GREAT FUN VACATIONS will not release personal information to ANY parties not listed on your finalized Travel Quote and will apply due diligence in maintaining records in a secure, safe location.

- All International travelers must have a valid passport book with 6 month validity.
-It is the travelers responsibility to ensure that they have proper identification, vaccinations & documents required to travel for all destinations.
-All deposits are NON REFUNDABLE
-Great Fun Vacations is not liable if traveler gets injured or sick while traveling.

On the date indicated below, I requested that [Great Fun Vacations(Agency)] make one or more travel bookings on my behalf. As the worldwide COVID-19 coronavirus pandemic remains ongoing at this time, I acknowledge that for this reason, and other reasons not reasonably foreseeable at this time, these travel plans may be interrupted or cancelled by the supplier that is providing them, a government entity or other third party over which Agency has no control. I further acknowledge that the supplier’s own cancellation, rebooking and refund policies, subject to any applicable law that is now or may later be in effect, will govern my rights and remedies, including my right to receive a refund, in such an event. Moreover, I understand that should I elect to purchase travel insurance, the terms of the policy will dictate whether, and to what extent, coverage for any financial loss may exist under the circumstances. By signing below, I hereby agree to hold Agency harmless and release it from any and all liability for any damages, including but not limited to monetary losses, I may incur as a result of such interruption or cancellation of these travel plans. *
I Agree to the Above Stated Terms
I have received, reviewed and agree to the Travel Vendor/Supplier/Operator "Terms and Conditions" for the purchase of this travel service/vacation package.

* "Terms and Conditions were included with your travel service/vacation quote.

**If female, I am not nor will be more than 24 weeks pregnant at time of travel** Per cruise and airline policies travel after 24 weeks is not authorized.** *
I Agree to the Above Stated Terms
Signature *
Clear
WITH MOUSE OR STYLUS - PLEASE SIGN ABOVE:

I consent to provide an electronic signature rather than a handwritten signature in connection with my Credit Card authorization. I submit my signature by typing my name above and checking the “I agree” box. I understand that my electronic signatures will be binding as though I had physically signed this document by hand. I agree that a printout of this authorization may be accepted with the same authority as the original.
Date Time
MM / DD / YYYY