Client Information Form

Client Information Form
Thank you for trusting the Upon A Star Travel Journeys Team with your group booking! As lead guest and point of contact, please fill out and complete this form in its entirety.
Full Name*
First NameMiddle NameLast Name
Phone Number*
Area CodePhone Number
Email*
example@example.com
Date of Birth*
MonthDayYear
Date
Mailing Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Changes and/or Cancellations
I have been advised of potential change/cancellation charges that may be implemented by the supplier in the event that I choose to cancel or change my booking after making the initial deposit.*
Reservations cancelled with in 60 days of your check in date are subject to a cancellation fee in the amount of the deposit. (payable to Travel Agent).*
Reservations cancelled with in 30 days of your check in date could be responsible for a cancellation fee in the amount of the full price of the reservation.*
I acknowledge that Upon A Star Travel and the Journeys Team are not liable for any cancellation charges from the contracted vendor.*
Credit Card Information: Please call, email or message us with the full card number and the CVV code from the back of card.
Card Type*
Card Holder Name*
Approved Amount*
(Deposit Per Group Contract)
Card Holder Authorization
I, the above-named authorized credit card user, give Upon A Star Travel & Concierge, LLC. and its representative express authorization to charge my credit card for the vacation related charges that I authorize via phone or email. I understand that this form constitutes a legally binding contract and that by affixing my signature to this form, I will be held responsible for charges as well as any and all collection and legal fees. By signing this "Credit Card Authorization" form, I/my organization acknowledge receipt and understanding of its contents.
We make every effort to honor the package price quoted originally, however; under certain circumstances your price may be subject to increase prior to full payment due to an increase in the cost for one or more of the travel components of your package. We will always notify you in such an event.
Prices will not increase after you make full payment, except for charges resulting from increases in government-imposed taxes or fees.
By signing below, you expressly acknowledge your acceptance of these conditions applicable to your purchase and by signing your name and initials you have read and agreed to this being your signature by electronic transfer to Upon A Star Travel & Concierge, LLC.
By signing below, I agree to the accuracy of the information disclosed within this form and to the authorization to charge my credit card for the amount specified above.
Signature*
Clear
Please make sure all information and spelling is correct before submitting!
Should be Empty:

Client Information Form

Please make sure all information and spelling is correct before submitting!