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Credit Card &
​Insurance Info

ESCAPE DESTINATIONS TRAVEL

IMPORTANT INFORMATION REGARDING TRAVEL INSURANCE  

Name: ______________________________________    

Now that you have arranged your trip, as a professional travel agent I feel that it is my responsibility to recommend travel insurance to protect your investment. Upon request, I will email you details about a specific policy and a quote. Call me with any questions you may have. 

AT THE TIME OF FIRST PAYMENT: 

 -I have been advised of the cancellation penalties for my purchase. 

 -I understand that Travel Insurance can protect me from possible loss of money due to supplier bankruptcy/default, unexpected trip cancellation/interruption due to accident, sickness or death, baggage loss, medical expenses and emergency air transportation cost. 

 -I understand that I must purchase Travel Insurance immediately to obtain maximum coverage. 

 -I understand that once Travel Insurance is purchased, it is non-refundable. 


AT THIS TIME, I/WE CHOOSE… (CHECK ONE) 

  □ To purchase the recommended insurance. 

  □ To decline the recommended insurance.  

Name (please print) __________________________________________________________ 

Signature________________________________________ Date: _____________________  

Please call our office with this information at (910) 379-4033 AND Scan and email to: escapedestinationstravel@gmail.com   

PLEASE READ THIS CAREFULLY!

 
Escape Destinations Travel

Cardholder Authorization Form  

 

Date: _____________ Name: _______________________________________  

Please let this document serve as my authorization to charge the amount of $___________ for the following services (please select all that apply): 

____ Cruise  ____ Hotel  ____ Car  ____ Flight   ____ Transportation ____ Shore Excursions  ____

Vacation Insurance _____ (by leaving this blank, you are declining travel insurance)   

 

Please Circle which type of Card:      Visa     MasterCard     American Express     Discover 

Credit Card #: ______________________________________________________ 

Name on Card: __________________________________________(please print). 

Exp. Date: ______________________CVV # (on back)_____________________________ 

Billing address: _____________________________________________________ 

City: __________________________________ State: ________ Zip: __________ 

Card holders signature: _____________________________________Date: ___________  

**I am aware of any cancellation policies and agree not to dispute or attempt to charge-back any of the above signed for and acknowledged charges. Escape Destinations Travel reserves the right to impose a cancellation fee above and beyond supplier fees in the amount of $50 per traveler. 

_____________ Cardholder initial  

There are no additional charges to make payments on your vacation, this is a free service we offer to our clientele. 

Escape Destinations Travel- Jen Campbell 110 North Church St. Roseboro, NC 28382.

Phone: 910.379.4033  

Email: escapedestinationstravel@gmail.com

Website: www.escapedestinationstravel.com

 


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© 2019 Escape Destinations Travel
Phone: (910) 379-4033 

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  • HOME
  • Vacations
    • All Inclusive Vacations
    • Honey Moon & Wedding Travel
    • Cruises >
      • Our Special Group Cruises!
    • Tours >
      • Scotland England 2021 Small Group Tour >
        • Scotland & England Itinerary
      • Germany Small Group Tours >
        • Meet Your Tour Guides
        • Germany-Sample Itinerary
    • Vacation Layaway Program!
  • Contact
  • About Us
  • Reviews
  • Resources
    • Terms & Conditions >
      • Credit Card & Insurance Authorization Forms
      • Disclosures & Acknowledgement
      • Privacy Policy
  • Travel Blog