EmailMe Form - Jewel Sky Getaways - Payment Authorization

Jewel Sky Getaways - Card Usage

I have accepted the quote given to me by JEWEL SKY GETAWAYS and authorize JEWEL SKY GETAWAYS 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 JEWEL SKY GETAWAYS; 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. I understand that JEWEL SKY GETAWAYS will impose the following charges when contractually applicable: all non-insured reservations are subject to Cancellation Fees of $25 per traveler will be applied to the provided credit card account. JEWEL SKY GETAWAYS 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.

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I Agree to the Above Stated Terms

Jewel Sky Getaways - Terms and Conditions

Our agency is an intermediary between the Suppliers and the public. Jewel Sky Getaways does not own or operate any of, the hotels, shore excursions, tours, transportation providers, cruise lines, vessels, airlines, travel protection companies, attractions, or other travel-related Suppliers who provide goods or services for the Passenger(s)’ trip. Passenger(s) acknowledge and agree that Jewel Sky Getaways shall not be responsible for any loss, damage, delay, inconvenience or injury to Passenger(s) or group members as a result of a breach of contract, act or omission whether willful or negligent, criminal or otherwise of any person other than JSG or its direct employees, including but not limited to these Suppliers, their employees, agents, servants, or representatives.

We do not need to know if you have a criminal history, BUT it is important that you understand any travel restrictions based on your criminal history. International travel, including cruises, will require an immigrations check that may not allow you to travel if you were convicted of a felony, have back child support, a DUl or other legal issues.
If you are on parole, you must have permission from your parole officer to travel. If you have finished your sentence, even if it was many years ago, we urge you to visit Travel.State. Gov and check for any restrictions to your destination. Some destinations have more strict rules than others. By submitting this form, you accept responsibility and absolve JEWEL SKY GETAWAYS of any responsibility if you are denied travel due to criminal history OR lack of proper documentation. Not checking this box will invalidate this form and no travel arrangements will be made.

I understand that it is my responsibility to have proper travel documentation for the destinations I am traveling to.

If I have questions about my travel documentation, I will refer to www.travel.state.gov and will ask questions of my travel agent well in advance of travel. JEWEL SKY GETAWAYS nor the agent, nor the tour operator in which I book my trip through are responsible for ensuring that I have proper travel documentation.

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I Understand and Agree to the Above Stated Terms and Conditions

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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.

Client's Full Name *

First Middle Last

Client/Card Holder's Email *

Confirm

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 City State / Province / Region Postal / Zip Code

Phone *

### - ### - ####

Type of Payment *

Initial Deposit

Partial Payment

Final Payment

Paid in Full at Booking

At the time of Initial Deposit and/or Payment please read and then check to indicate understanding of each of the following: *

I have been ADIVISED of the cancelation penalties related to my purchase.

I UNDERSTAND that travel protection can protect me from possible loss of money due to supplier bankruptcy/default.

I also UNDERSTAND that Travel Protection can cover accidents, sickness and/or death.

I further UNDERSTAND that Travel Protection can cover baggage loss, medical expenses, and emergenct air transportation costs.

Travel Protection Option *

I ACCEPT TRAVEL PROTECTION COVERAGE

I DECLINE TRAVEL PROTECTION COVERAGE

I AM UNDECIDED (MUST PURCHASE WITHING 21 DAYS OF INITIAL DEPOSIT TO RECEIVE PRE-EXISTING CONDITIONS COVERAGE)

Payment Option *

One Time Only

Monthly Payment Plan

**THE MONTHLY PAYMENT PLAN CANNOT EXTEND PAST THE SUPPLIER FINAL PAYMENT DATE**

Monthly Payment
Plan Date Request *

Please select the day you would like your payment to be submitted each month.

Type of Credit Card to be Used in this Transaction *

VISA

Master Card

Discover

American Express

Credit Card *

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

Duration Option for Monthly Payment Plan *

Balance Due *

$ Dollars . Cents

Please enter the amount of the balance due to you on your reservation.

Amount to be charged monthly *

$ Dollars . Cents

I hereby authorize Jewel Sky Getaways to retain this credit card payment information on their secured server for the purpose of future payments on this reservation to fulfill the Monthly Payment Plan agreement. *

YES

NO

Amount to be charged *

$ Dollars . Cents

Any Comments regarding the dollar amount to be charged in this transaction:

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 below 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. *

I Agree

Please note payments marked as "Paid in Full" and/or "Final Payment" will not be processed UNLESS the CORRECT amount of full cost of the vacation/travel charges will be paid in full and/or final payment does result in a zero balance on the account. Please call me to confirm your payment(s) if you have not already received this information from me. 870-373-1683

Additonal Comments

Please provide any additional information needed to complete your booking and/or payment.

Electronic Signature: *

Hazardous Materials *

I understand that federal law forbids the carriage of certain hazardous materials, such as aerosols, fireworks, and flammable liquids, aboard the aircraft.

* If you do not understand these restrictions, contact your airline or go to

http://www.faa.gov/about/initiatives/hazmat_safety