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Credit Card Authorization & Insurance Form

For your protection as well as ours, we will need the following authorization to charge your credit card, for your travel arrangements.
Please keep in mind the terms and conditions and cancellation policy on your reservation set by the Walt Disney Travel Company and other destinations .

Travel Insurance: Please note that travel insurance has been offered and choose from the following options. Choosing the option "No, I do not wish to purchase travel insurance" is your agreement to deny the purchase of travel insurance and will not hold Just A Dream Away Travel, LLC responsible for any losses/expenses due to travel situations that may arise.

*Please note: There are fees associated with cancelling insurance once it has been purchased. However, it sometimes may be added at a later time. Please speak with your Travel Professional, for further details.

Insurance Agreement and Payment Authorization

Travel Insurance

YES! - I DO want to purchase Travel Insurance at this time
NO - I DO NOT wish to purchase Travel Insurance at this time

Credit Card Authorization

Name as it appears on the card

Billing Address

Street

City, State, Zip

Type of Card

Card Number (if given by phone - write in last 4 digits)

Expiration

Security Code (3 digits on back of card)

Phone

Card Number Given Verbally

Card # Given by Phone
Other

Future Charges

Keep this card on file for future charges associated with this booking

See reservation confirmation for cancellation and change policies.

By submitting below, I authorize Just A Dream Away Travel, LLC to charge my credit/debit card in the amount agreed upon between Just A Dream Away Travel, LLC and myself.

I agree

Amount Authorized to be charged with the submission of this form

Cancellations: For cancellations any and all trip cancellations, I agree to the terms and conditions set forth by the travel supplier/vendor and Travel Agency.

I have read, understand and agree to the above cancellation policy.

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. 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 submitting this form you have read and agreed to this being your signature by electronic transfer to Just A Dream Away Travel, LLC. Please note: Prices quoted are not guaranteed unless a deposit has been applied to your reservation.

I agree to all terms of service, including travel insurance, cancellations, disclosure and consent to authorize payment to Just A Dream Away Travel, LLC.

Digital Signature: By typing my digital signature below, In lieu of my credit card imprint, I authorize Just A Dream Away Travel, LLC to charge my credit/debit card in the amount agreed upon between Just A Dream Away Travel, LLC and myself, for the purpose of paying for travel services, including air tickets, travel related charges and service fees.