Secure Travel Payment Sign-Up Form

Simple, secure access to manage your travel payment details and confirmation.

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Comments

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Travel Insurance

TRAVEL INSURANCE I understand travel insurance has been offered to me for purchase to cover certain risks inherent in travel such as supplier bankruptcy, trip interruption and/or the inability to travel due to a medical or personal emergency. If I choose not to purchase travel insurance or if I purchase travel insurance on my own (not through World Adventure Travels), I understand that World Adventure Travels requires that This is to confirm that, in keeping with all applicable laws, I am instructing World Adventure Travels, Inc. to purchase travel and/or travel insurance against the form of payment per World Adventure Travels Credit Card Authorization form. I further understand that I have authorized this transaction and will hold World Adventure Travels and affiliated travel agents harmless with respect to these instructions. It is understood that the above agency may request government issued photo identification and may verify the billing address of my credit card.

Accept or Decline Travel Insurance* I have acknowledged to my travel agent at World Adventure Travels, inc. whether I have chosen to accept or decline travel insurance to be included in this quote or to be purchased for this current vacation. If I declined at this time and decide at a later time to purchase Travel Insurance for my vacation package quoted by World Adventure Travels and their affiliated travel agents, I will supply in writing a letter of request to purchase Travel Insurance either by letter or electronic form of an email.

Do you understand your travel insurance options?*

Do you wish to purchase travel / cancelation insurance?*

Agent Name

Up to total amount authorized

Traveler One*

First Middle Last

Gender*

U.S. Citizen*

Date of Birth*

Traveler Two*

First Middle Last

Gender*

U.S. Citizen*

Date of Birth*

PAYMENT INFORMATION
(P.O. Boxes Not Accepted)

Name*

First Last

Address*

Address City State ZIP Code

Preferred Phone*

E-mail*

Name as it appears on card*

Amount to pay*

Credit Card Number*

Card Type*

CVV Number*

Expiration Date

Additional information or special request

I authorize World Adventure Travels and their affiliated Travel Agents to regularly charge my card on the current booking that I have entered into agreement with. World Adventure Travels and their affiliated travel agents have my permission to charge my credit card for the amount indicated in this form. World Adventure Travels and their affiliated travel agents have my permission to charge any and all remaining balances and or any additional charges upon my request from the date of initial purchase on a regular basis until my booking has been paid in full without having to fill out this form again, and shall remain in effect until I request for the cancellation or termination. I likewise certify that I am the authorized user of the Credit Card that shall be submitted through this form. As long as the transactions correspond to the terms and conditions indicated in this authorization, I shall not raise disputes against World Adventure Travels.

I understand all of the terms and conditions regarding this booking including cancellation policies, applicable penalties, and the availability of travel insurance.

If you are using a debit card with a daily spending limit, it is your responsibility to contact your bank to give them permission to authorize the transaction. If they require the name of the vendor and you are unsure as to who that is, please contact World Adventure Travels (828) 734-1317.

By Signing this form, I authorize World Adventure Travels and their affiliated Travel Agents to process my credit card listed above per our agreement: By typing my name is the same consent as my signature in a digital format.

Signature*

Date of Authorization*