e4 Travel - Credit Card Authorization Form
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.

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

Agent Name: Regina Dunbar Hendrickson
Agent ID#20027808
  • e4 Travel and Events Authorization - Card Usage

    I have accepted the quote given to me by e4 TRAVEL & EVENTS and authorize e4 TRAVEL & EVENTS 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 e4 TRAVEL & EVENTS; 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 e4 TRAVEL & EVENTS will impose the following charges when contractually applicable: all non-insured reservations are subject to Cancellation Fees of $35 per traveler will be applied to the provided credit card account. e4 TRAVEL & EVENTS will not release personal information to ANY parties not listed on you finalized Travel Quote and will apply due diligence in maintaining records in a secure, safe location.
  • * "Terms and Conditions were included with your travel service/vacation quote.
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  • Please type your credit card number in exactly as on your credit card. Failure to do so may result in e4 Travel and Events being unable to obtain your booking and loss of quoted price.
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  • 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 chargers 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. 618-667-1362 or 618-520-1144.

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