Passenger 1 Payment/Trip Information
    Legal Passport Name *

    Birthdate *

    Arrival date *

    Which Payment Is this?

    Card Number *

    Street Address *

    Zip Associated w/Card *

    Room Category/Cabin Type *

    Email *

    Gender

    Departure Date

    Amount *

    Card Expiration Date *
    [mask* mask-72 "__/__" "MM/YY"]
    City *

    Country

    Hotel/Cruise Information

    Phone *

    Do You Want Travel Insurance *
    Please include the travel insurance cost with your initial trip deposit. If you select yes to travel insurance, your card will be charged the insurance cost and cannot be refunded or transferred. Valid on new bookings only.

    Exquisite Agent Name *

    Card Holder Name *

    CVV *

    State *

    Wedding/Group name (if applicable) *

    Comment(Additional guests, Children's Names, Date of Birth) *

    Passenger 2 Payment/Trip Information
    Legal Passport Name

    Birthdate

    Email

    Gender
    Phone

    Do You Want Travel Insurance
    Please include the travel insurance cost with your initial trip deposit. If you select yes to travel insurance, your card will be charged the insurance cost and cannot be refunded or transferred. Valid on new bookings only.

    Passenger 3 Payment/Trip Information
    Legal Passport Name

    Birthdate
    Email

    Gender
    Phone

    Do You Want Travel Insurance
    Please include the travel insurance cost with your initial trip deposit. If you select yes to travel insurance, your card will be charged the insurance cost and cannot be refunded or transferred. Valid on new bookings only.

    Passenger 4 Payment/Trip Information
    Legal Passport Name

    Birthdate
    Email

    Gender

    Phone

    Do You Want Travel Insurance
    Please include the travel insurance cost with your initial trip deposit. If you select yes to travel insurance, your card will be charged the insurance cost and cannot be refunded or transferred. Valid on new bookings only.

    Terms and Conditions

    If this is a debit card, you may have a daily limit on your card, so please advise your bank if your payment amount is more than your daily limit or your charges may decline.

    By signing below and submitting my payment, I acknowledge I am the cardholder and authorize Exquisite Vacations Inc., and its Tour Wholesaler / Cruise Lines to charge the amount to my credit card. I accept the charges described herein and understand that should my travel plans change, and I did not purchase travel insurance, I may not be entitled to a full refund and that cancellation and or change fees may apply. If I purchased travel insurance, my cancellation penalties would be adjusted or waived, based on the terms of the policy purchased. Travel Insurance Premium are nonrefundable once purchased. I accept that Exquisite Vacations Inc, its travel tour wholesalers /cruise lines and its independent agent are acting fully upon my direction and that I will not hold them responsible for acts beyond their immediate control as it relates to this charge and that I will make payment according to the terms of my agreement with the credit card company. Please note all payments are in US (USD) Dollars.