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Home
Services
Vacation Packages
Caribbean Carnival Packages
Event Planning
Trips
Destinations
Travel Tips
Blog
Contact Us
Payment Authorization & Agreement
Client Information: TRAVELER(S) NAME: (AS IT APPEARS IN PASSPORT)
First Name
*
Middle Name
Last Name
Contact Phone Number
*
Contact Email Address
*
Street Address
*
Apt / Unit
City
*
State
*
Zip Code
*
Passport
Issue Date
*
Exp. Date
*
Birthdate
*
2nd Traveler’s (Roommate Information) (If applicable)
First Name
Middle Name
Last Name
Contact Phone Number
Contact Email Address
Street Address
Apt / Unit
City
State
Zip Code
Passport
Issue Date
Exp. Date
Birthdate
Select your preferred room type.
Double
Twin
Single
Suite Number of Guest(s) per room
Please note: Double room implies room with 2 guests sharing a double, queen or king bed, as available at time of check in. Twin room implies room with 2 twin beds. We cannot guarantee any specific bed type in advance.
EMERGENCY CONTACT
IN CASE OF EMERGENCY, PLEASE CONTACT
RELATIONSHIP
TELEPHONE (DAY)
TELEPHONE (EVENING)
COVID-19 HEALTH WAIVER STATEMENT
Ms. Travelista Inc. and its Travel Advisors have provided clients with the best available information as it relates to COVID-19, protective policies, practices of the suppliers involved in planning clients’ vacations, tours, and events. The client (you) understands that the suppliers, tour vendors, airlines, hotels, villas, travel vendors, may not apply those policies as diligently as the policies suggest. Even if the supplier makes a good faith effort to enforce its good practices some travelers may simply refuse to cooperate. Ms. Travelista Inc. nor its Travel Advisors are not responsible and/nor liable for the actions of suppliers/vendors and travelers resulting in clients’ becoming infected (sick) by COVID-19 or any other pandemic or health issue.
PAYMENT AUTHORITY
CLIENT: I authorize Ms. Travelista, LLC to bill my credit card on behalf of all associated suppliers for the charges detailed in itinerary.
Trip Description
*
Name of Cardholder
*
Billing Address
*
City
*
State
*
Zipcode
Credit Card Number
*
Card Type
Expiration
CVV
Cardholder Signature
*All credit card information will be deleted once payment is processed unless requested to remain on file for payment plan schedule.
NOTES (Include additional travelers’ information or special request):
This form must be completed, signed, and received by Ms. Travelista, Inc. no later than final payment date. Ms. Travelista, Inc. will not be responsible for any consequences due to errors because of misspelled names. Any action or inaction taken by an airline or other transportation company is the sole responsibility of the guest. A signed agreement form is an acceptance of the hotel reservation, rate confirmed, and constitutes acceptance of this agreement.
I have read and understand this agreement.
*
Yes
SIGNATURE
*
DATE
*
I understand an electronic signature has the same legal effect and can be enforced in the same way as a written signature.
Thank you!
