Consent
By completing this form, I, the individual identified in the credit card information section above, authorize the agent or agency providing this form on this website or by email, or their authorized representative, to charge my credit card listed on this document for reservation for the trip departing on . I understand all the terms and conditions of this booking and agree to the terms and conditions made available 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 communication between Moments To Memories Travel 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. I, the above-named Cardholder or authorized representative, 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.
Verbal Approval Authorization