EmailMe Form - Credit Card / Insurance/Travel Waiver

Credit Card / Insurance/Travel Waiver

PAYMENT AUTHORIZATION, TERMS, & CONDITIONS

I hereby authorize Simply Travel, LLC to use this information to make any and all payments directly to the relevant travel suppliers for all my approved travel plans. I certify that I am an authorized user of this credit card and that 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 confirm that all itinerary information is correct; any alterations to the trip may result in extra fees. I acknowledge that I am purchasing this trip from a travel agency and not a hotel, airline, or other travel supplier directly, therefore, the transaction can’t be canceled due to service dissatisfaction. By signing my name below, I acknowledge that I have read and agree to the cancellation terms of all elements of my purchase. I am also responsible for having an up-to-date passport, travel documents, visas, and any other required proof of citizenship, and I am responsible for any consequences that may arise from not having them. I also understand that I need to check-in at least 2 hours before my flights, late check in will result in denial of boarding at my own expense. I understand that I am responsible for keeping track of all payment due dates. Late final payments will result in forfeit of deposit. I furthermore agree that my submission of this form electronically via email or facsimile shall constitute the execution of this agreement in exactly the same manner as if I had signed, by hand, a paper version of this document. I acknowledge that Simply Travel, LLC cannot control the cancellation fees assessed by the Tour Operators, or third parties, nor control issuance of vouchers in lieu of cash. I understand that should I initiate any chargeback with my credit card company to avoid previously agreed upon fees Simply Travel, LLC will utilize all rights and remedies under the laws of the State of STATE, to uphold previously agreed contractual provisions. I agree that any service fees imposed by Simply Travel, LLC will be nonrefundable and are not subject to a chargeback. I understand Simply Travel, LLC does this because third parties seek payment directly from Simply Travel, LLC. The cancellation fees do not cease to exist in the event of a chargeback. Thus, Simply Travel, LLC will be prompted to pursue litigation and incur attorney’s fees and costs which will be included in addition to all cancellation fees. I also agree to the Terms & Conditions of Simply Travel, LLC and to the consent to use my personal information and understand that by using Simply Travel, LLC services for the booking of any travel services that certain personal identifying information may be conveyed to third parties relevant and necessary to the transportation and accommodation of my travel. Simply Travel, LLC shall not be responsible for the further use of said information by third parties by the customer.

Please charge the following amount to my credit card for my travel arrangements as agreed to by me verbally or in writing via email or text to Simply Travel, LLC.
$ Dollars . Cents
Credit Card *

Card Number

Protected in vault Data collected via fields that have our security seal are encrypted and stored with the highest global security standard — PCI compliance. Your data is absolutely safe in Vault.
Name as it reads on your credit card and billing address.
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Print your name as it reads on your Credit Card.
Electronic Signature *
Clear
TRAVEL INSURANCE WAIVER

PAYMENT AUTHORIZATION, TERMS, & CONDITIONS
I hereby authorize Simply Travel, LLC to use this information to make any and all payments directly to the relevant travel suppliers for all my approved travel plans. I certify that I am an authorized user of this credit card and that 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 confirm that all itinerary information is correct; any alterations to the trip may result in extra fees. I acknowledge that I am purchasing this trip from a travel agency and not a hotel, airline, or other travel supplier directly, therefore, the transaction can’t be canceled due to service dissatisfaction. By signing my name below, I acknowledge that I have read and agree to the cancellation terms of all elements of my purchase. I am also responsible for having an up-to-date passport, travel documents, visas, and any other required proof of citizenship, and I am responsible for any consequences that may arise from not having them. I also understand that I need to check-in at least 2 hours before my flights, late check in will result in denial of boarding at my own expense. I understand that I am responsible for keeping track of all payment due dates. Late final payments will result in forfeit of deposit. I furthermore agree that my submission of this form electronically via email or facsimile shall constitute the execution of this agreement in exactly the same manner as if I had signed, by hand, a paper version of this document. I acknowledge that Simply Travel, LLC cannot control the cancellation fees assessed by the Tour Operators, or third parties, nor control issuance of vouchers in lieu of cash. I understand that should I initiate any chargeback with my credit card company to avoid previously agreed upon fees Simply Travel, LLC will utilize all rights and remedies under the laws of the State of STATE, to uphold previously agreed contractual provisions. I agree that any service fees imposed by Simply Travel, LLC will be nonrefundable and are not subject to a chargeback. I understand Simply Travel, LLC does this because third parties seek payment directly from Simply Travel, LLC. The cancellation fees do not cease to exist in the event of a chargeback. Thus, Simply Travel, LLC will be prompted to pursue litigation and incur attorney’s fees and costs which will be included in addition to all cancellation fees. I also agree to the Terms & Conditions of Simply Travel, LLC and to the consent to use my personal information and understand that by using Simply Travel, LLC services for the booking of any travel services that certain personal identifying information may be conveyed to third parties relevant and necessary to the transportation and accommodation of my travel. Simply Travel, LLC shall not be responsible for the further use of said information by third parties by the customer.
I choose to purchase travel insurance
I decline to purchase travel insurance
Date
MM / DD / YYYY
Print your name
Electronic Signature *
Clear
TRAVEL RISK WAIVER

PAYMENT AUTHORIZATION, TERMS, & CONDITIONS
I hereby authorize Simply Travel, LLC to use this information to make any and all payments directly to the relevant travel suppliers for all my approved travel plans. I certify that I am an authorized user of this credit card and that 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 confirm that all itinerary information is correct; any alterations to the trip may result in extra fees. I acknowledge that I am purchasing this trip from a travel agency and not a hotel, airline, or other travel supplier directly, therefore, the transaction can’t be canceled due to service dissatisfaction. By signing my name below, I acknowledge that I have read and agree to the cancellation terms of all elements of my purchase. I am also responsible for having an up-to-date passport, travel documents, visas, and any other required proof of citizenship, and I am responsible for any consequences that may arise from not having them. I also understand that I need to check-in at least 2 hours before my flights, late check in will result in denial of boarding at my own expense. I understand that I am responsible for keeping track of all payment due dates. Late final payments will result in forfeit of deposit. I furthermore agree that my submission of this form electronically via email or facsimile shall constitute the execution of this agreement in exactly the same manner as if I had signed, by hand, a paper version of this document. I acknowledge that Simply Travel, LLC cannot control the cancellation fees assessed by the Tour Operators, or third parties, nor control issuance of vouchers in lieu of cash. I understand that should I initiate any chargeback with my credit card company to avoid previously agreed upon fees Simply Travel, LLC will utilize all rights and remedies under the laws of the State of STATE, to uphold previously agreed contractual provisions. I agree that any service fees imposed by Simply Travel, LLC will be nonrefundable and are not subject to a chargeback. I understand Simply Travel, LLC does this because third parties seek payment directly from Simply Travel, LLC. The cancellation fees do not cease to exist in the event of a chargeback. Thus, Simply Travel, LLC will be prompted to pursue litigation and incur attorney’s fees and costs which will be included in addition to all cancellation fees. I also agree to the Terms & Conditions of Simply Travel, LLC and to the consent to use my personal information and understand that by using Simply Travel, LLC services for the booking of any travel services that certain personal identifying information may be conveyed to third parties relevant and necessary to the transportation and accommodation of my travel. Simply Travel, LLC shall not be responsible for the further use of said information by third parties by the customer.
Print your name
Electronic Signature *
Clear
*
I (We) consent to Simply Travel, LLC collecting all personal information provided on this form. Including but not limited to name, address, phone number, email, and credit card information.