EmailMe Form - Credit Card Payment

EmailMeForm

Name on Reservation *
First Last
Email *
Email you would like your confirmation sent to
Name of Resort, Cruise, or Flight you are making a payment for *
Would you like Travel Insurance? *
Yes- please add travel insurance shown on my quote/invoice
No- I decline travel insurance and understand my risks
Please indicate the amount to be charged to your credit card *
$ Dollars . Cents
Payment will not show up immediately, as I have to submit payment to vendor.
Name on Credit Card *
First Last
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 *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Credit Card Signature Required

I am giving Cruise Planners-Jeanette Esposito authorization to process my credit card for the amount requested or the amount due by the Cruise Line or Travel Supplier.

In lieu of my credit card imprint, I (card holder) hereby authorize Cruise Planners-Jeanette Esposito to use my credit card information to process payments for the travel as agreed upon with the travel supplier.

I agree to be bound by the Terms and Conditions related to this charge. I understand in the event of cancellation or change that financial penalties may be assessed according to Cruise Planners-Jeanette Esposito or travel supplier's terms. I will not hold Cruise Planners or agent liable for these charges. *
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Additional Comments
Use this box for any questions or comments regarding your reservation.