Credit Card Authorization

PLEASE SUBMIT A PAYMENT

Please fill out the form below to securely submit your payment information. If you have any questions or need further information please contact Tara at tara@adventuresassembledtravel.com

PAYMENT INFORMATION

BILLING INFORMATION

Please charge my credit card referenced above in the amount indicated.  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 Adventures Assembled Travel Co

In lieu of my credit card imprint I acknowledge that I am the cardholder listed above and authorize Adventures Assembled Travel Co to charge my credit card.
I authorize Adventures Assembled Travel Co to charge my credit card account listed on this document for the travel related charges above. I understand all the terms and conditions of this booking and agree to the terms and conditions provided to me for this travel arrangement, including all cancellation policies. I understand and agree that travel arrangements may be subject to non-refundable cancellation penalties. I agree to carefully read all emailed communications between Adventures Assembled Travel Co and myself and note all restrictions that may apply. I further understand that as part of your travel services, you recommend that all travelers purchase some form of travel insurance to help protect their travel investment.
If this document is signed on behalf of the cardholder, the signatory has been authorized by the cardholder and cardholder accepts all responsibilities for charges.
I certify that the information provided on this form is true and correct. I am authorized to effect charges on the credit card number provided. I agree that in the event of a discrepancy to my credit card account, I will notify your agency's accounting department within seven (7) business days of receiving the credit card statement or immediately upon knowledge of such error.
As the credit card holder, I authorize Adventures Assembled Travel Co to charge my credit card for future payments approved by me. Payment requests must be via email.
Authorization Valid until date of travel or 1 year from date of submission, whichever is sooner.

By clicking the "submit my payment" button you are electronically agreeing to the terms and conditions as outlined.

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