CREDIT CARD AUTHORIZATION FORM

TRIP REGISTRATION & CREDIT CARD AUTHORIZATION FORM

Daiquiri Tours is requesting authorization from the card holder to charge your credit card for travel-related purchases. By filling out and signing this form you grant permission to Daiquiri Tours to do so for the services listed below, which are services that you have requested to purchase. In some cases, charges on your card may appear from third parties used by Daiquiri Tours to fulfill your travel-related services.
E-mail
Billing Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Amount to be Charged (TOTAL)
PLEASE NOTE: Once this form is received, you will be sent a separate invoice where you can choose to pay online or call our office with your credit card number.
Services to be Charged
please provide as many details as possible, including number of travelers and services purchased
Emergency Contact Information
Name (person not traveling with you)

First NameLast Name
Relationship
Contact Number

Area CodePhone Number
Any medical conditions or allergies we should be aware of ?
Passport information
Number of Travelers
Please fill out passport information for each traveler on your booking (make sure to hit the "Add Traveler" button to add as many people as needed). It is the responsibility of the traveler(s) to fill out the names, dates and numbers exactly as they appear on passport(s) or the traveler(s) may be denied services, including access to hotels, tour, flights and any other services booked with the travel package.
Passport Details
Trip Details
Name of Program (i.e. Italy's Classic Three, Dreaming of Havana, etc.)
Number of Rooms
Please select the bedding preference for each one of the rooms you are booking (make sure to hit the "Add Room" button to add as many rooms as needed)
Departure Date from US:

MonthDayYear
Departure date
Arrival Date in Destination (plus one day in Europe):

MonthDayYear
Arrival date
I agree to purchase the above travel-related services and agree to pay for these services with the above credit card. I understand that the payment may come from a third party contracted by Daiquiri Tours to fulfill my travel-related services, and in some cases multiple charges may be applied.

I agree to all terms and conditions and understand that a refund may not be possible after the travel services are confirmed. ALL FLIGHTS purchased are subject to the airline's policies, and not Daiquiri's terms and conditions, and in most cases are non-refundable/non-changeable tickets.

In order to travel internationally you must have a valid passport (in some countries valid for at least 6 months of your return date) and visas (where applicable) and I understand that it is my responsibility to obtain such travel documents prior to my travel date.

We recommend purchasing travel insurance to protect your travel investment. You may request a quote here: INSURANCE QUOTE
Would you like to purchase travel insurance?*
Signature

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TRIP REGISTRATION & CREDIT CARD AUTHORIZATION FORM

Emergency Contact Information

Please select the bedding preference for each one of the rooms you are booking (make sure to hit the "Add Room" button to add as many rooms as needed)