One Time or Payment Plan Credit Card Authorization Form

Credit Card Holder Legal Name*

First

Last

Card Number*

Card Expiration Date*

CVV *

Street Address*

City*

State *

Zip Associated w/Card *

Email address*

Phone*

Exquisite Agent Name*

Today's Payment Amount

Today's Payment Date

Schedule Payment Amount

Schedule Payment Date

Schedule Payment Amount

Schedule Payment Date

Comment

Terms and Conditions*

By signing below, I acknowledge and accept the charges described herein and understand that should my travel plans change, and I did not purchase insurance, I may not be entitled to a full refund and that cancellation or change fees may apply. If I purchased insurance, my cancellation penalties would be adjusted or waived, based on the terms of the policy purchased. I accept that the travel suppliers 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. Consented: I agree to the terms and conditions of this purchase agreement, including the cancellation & refund policy provided by Exquisite Vacations Inc.

I agree to the terms listed on my invoice and or wedding group page.

I approve the agency and/or its affiliates to charge me for the deposit of this invoice at this time. I further approve the agency and/or its affiliates to charge my card for the final balance on the final payment due date listed on my invoice. If I want to change the credit card on file, I will provide the new credit card info at least 7 days prior to the final payment date.

I hereby verify that I have reviewed my travel itinerary for accuracy. I have been advised of all applicable charges imposed by Exquisite Vacations Inc., plus I have been offered the option of purchasing trip cancellation/interruption insurance. I understand that discounted fares and vacation packages typically involve restrictions and that changing any aspect of my travel arrangements may result in payment of additional money. Furthermore, I understand if trip cancellation insurance has not been purchased, the package will be non-refundable or non-cancellable and I will be liable for the entire package price owed.

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