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Credit Card Authorization


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Please use this card for all charges related to this trip.  I understand that my card will be charged a minimum of 3-days prior to final payment.

Please use this card for the amount listed. I will be sent additional authorizations for future payments.

Payment Authorization

I authorize Via Travel Service LLC to use this information to directly make all payments, up to the amount specified in this form, to suppliers for all my approved travel plans. I certify that I am an authorized user of this credit card. I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form. I also reviewed all trip details and confirmed that all information is correct; any alterations to the trip may result in extra fees. I acknowledge that I am purchasing this trip from a travel agent and not a hotel, airline, or another travel supplier directly. Therefore, I can not cancel my payment due to service dissatisfaction.

Cancellation Terms Acknowledgment

I acknowledge that I have been provided, read, and agree to the cancellation terms of all elements of my purchase.


Travel Documents

I understand that I am solely responsible for having an up-to-date passport, travel documents, visas, and original vaccination record if required. I am responsible for any consequences that may arise from not having these documents. I understand that my passport must have at least six full months of validity past my planned return travel date.

COVID-19 Disclosure

I understand that I am booking my vacation during a global pandemic. I will not hold Via Travel Service responsible for any consequence of this action. I may get infected with COVID-19 during my vacation, and I will not hold Via Travel Service responsible in any way. Due to the current pandemic, I may not have a normal travel experience. My experience may be impacted by COVID-19 related restrictions and closures imposed by governments and private businesses, staff shortages, supply shortages, or the like. I understand that COVID-19 related restrictions and requirements may change at any time. I understand that refusal to follow COVID-19 protocols of governments or private businesses may result in financial and legal penalties and loss of services paid with no refunds possible.

Travel Insurance

I understand that it is my right to request and receive a quote for travel insurance from one of Via Travel Service partners. I understand that I have a right to purchase travel insurance from the party of my choosing and that if I would like a quote from my travel advisor, I must request it. I understand that I must purchase travel insurance immediately to qualify for all coverages and avoid having a window with no coverage. If you have not yet received a quote for travel insurance and would like to purchase travel insurance, please reach out to your travel advisor for a quote.

Airport Arrival Time

I understand that I need to check-in at least 2 hours before domestic flights and 3 hours for international flights; late check-in may result in denial of boarding at my own expense.

Future Payments

I understand that I am responsible for keeping track of all payment due dates. Late final payments will result in a forfeit of deposit.

Validity of this Agreement

I understand that typing my name below and submitting this form constitutes the execution of this agreement in exactly the same manner as if I had signed, by hand, a paper version of this document.

Please sign below to authorize Via Travel Service to make your payment and acknowledge the terms.

Your payment will be processed within 24 hours. If you need to make any changes to this payment amount, please reach out as soon as possible.​

Thank you!

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