Travels by Charlotte Trip Deposit

The purpose of this credit card authorization form is to protect you, our valued clients, as well as Travels By Charlotte from credit card fraud. All information on this form will be kept strictly confidential and encrypted. This form MUST be submitted before any credit card payments for travel on your behalf will be made.
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Your Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please provide your FULL NAME as it appears on your passport OR birth certificate. (Your form of ID must match your boarding pass.)

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Untitled

Vacation Details

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Travelers' Information

NAMES MUST BE AS THEY APPEAR ON YOUR PASSPORTS FULL COMPLETE NAME-NO INITIALS

Failure to give proper name will result in denial into your destination which would result in no refunds- read form completely before signing. 
 
If traveling within the USA you do not need to include your passport information unless you will be using your passport as your identification at check in.
(Include all traveling with you as well as yourself. Print names as they appear on passports, If not traveling internationally print names as they appear on Government Issued ID.)
Roommate Information
Traveler # {binding ItemNumber}
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Gender {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Information required for travelers 21+ years old

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Information required for travelers 21+ years old

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Allergies/Special Accommodations
Please select one or more choices {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Emergency Contact Person

Only one emergency contact per family is needed

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Do you currently have a passport with at least 2 blank pages and with an expiration date after (date six months after return date)? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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A passport is required in order to go on this trip. This does not affect your ability to register for this trip at this time so please submit your payment as soon as possible. Just be aware that you are responsible for obtaining a valid passport.

Please either apply for a new passport or renew your passport if it expires after the date given. It takes 4-6 weeks to receive your passport in the mail.

CLICK HERE to begin the process. 

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Untitled
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Nationality {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Country of Issue {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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  • Spelling of name must be exactly as it appears on your valid passport book.
  • Travels By Charlotte is not responsible for denied boarding if provided with incorrect passenger information or if your passport is expired, not valid or incorrect proof of citizenship.
  • It is the responsibility of the passenger to confirm entry into another country if passport expires in 6 months or less at time of travel or if eligible to travel to all countries that are part of their travel itinerary. This includes any stops in countries which may be part of the “in-transit” itinerary.
  • If you are unsure about your eligibility to travel, including restrictions due to criminal records, child support issues or DUI’s please inform me immediately.
  • All bookings are non-refundable.
  • Any changes to the reservation will result in fees
Passport/Government ID Information & Status Acknowledgement {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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COVID-19 Waiver of Liability and Assumption of Risk

READ THIS DOCUMENT CAREFULLY—IT IS A RELEASE OF YOUR LEGAL RIGHTS.

The novel coronavirus, COVID-19, was declared a worldwide pandemic by the World Health Organization in March 2020. COVID-19 is highly contagious and is believed to spread mainly from person-to-person contact, through respiratory droplets and aerosol transmission. The U.S. State Department raised its global travel warning to the highest level, which recommends that citizens avoid all international travel, and makes clear that repatriation (returning to your home country) may not be provided and travelers may be stuck abroad. Most governments and public health agencies recommend social distancing and have, in many locations, restricted travel and congregations of groups of people. Even those destinations that allow visitors have limited or closed tourist sites and activities, or may do so in the future with no announcement. It is believed that traveling increases the risk of contracting COVID-19 due to decreased social distancing, increased exposure to people who may be contagious, and lack of due care or poor sanitization standards by those around you or suppliers, among other possible reasons.

I acknowledge that I am aware of: (1) the contagious nature of COVID-19; (2) the risk that I and my travel companions may become exposed to and/or infected with COVID-19 before, during, or after travel, which may result in personal injury, financial loss, illness, permanent disability, and/or death; (3) the risk that I and/or my travel companions may become subject to mandatory quarantines or other similar measures and their related costs; and (4) the risk that my travel plans, activities, and plans to return home or to work may become interrupted, delayed, canceled, or otherwise ruined due to COVID-19. I also acknowledge that infection or exposure to COVID-19 may result from the acts, omissions, or negligence of others, including but not limited to travel providers (for example: airlines, hotels, transportation companies, buses, trains, ships, tour guides, tourist site operators, and tour operators), Travels By Charlotte, LLC, my travel companions, and other persons. With full knowledge of these risks, I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury, illness, damage, loss, claim, liability, or expense, of any kind, to myself or the travel companions for whom I book travel, as a result of these risks.

I understand that the destination may require certain protocols to enter into their country and I and/or my travel companions will comply with those requirements.  I and/or my travel companions understand that if we do not comply, this will result in denial into the country, trip cancellation or being quarantined. This will also result in not being refunded for any monies lost or any days missed. 

Travels By Charlotte, LLC., is providing me with its travel planning and booking services. In exchange, I release, promise and covenant not to sue, discharge, indemnify, and hold harmless Travels By Charlotte, LLC., and any of its officers, employees, and agents from any and all liabilities, claims, demands, lawsuits, actions, liabilities, and causes of action, directly or indirectly arising out of or related to any damage, injury, death, or loss that may be sustained by me or those in my traveling party for whom I book travel, related to COVID­19. I acknowledge and agree that I am releasing all claims based on the acts, omissions, or negligence of Travels By Charlotte, LLC., its employees, agents, and representatives to the fullest extent permitted by law.

I HAVE CAREFULLY READ THIS DOCUMENT, I UNDERSTAND WHAT IT MEANS, AND I ACKNOWLEDGE THAT BY SIGNING BELOW, I AM BINDING MYSELF and releasing legal rights for everyone in my travel party.

 

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Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Travel Protection

I understand that by checking the appropriate box, I am accepting or declining travel insurance for the entire party on this itinerary/form and if we are accepting, the amount is added to the deposit amount that is due. I have been given travel insurance information and I am accepting or declining to purchase with full knowledge of the coverage and have been explained the importance of travel insurance. I understand that if my roommate cancelsand if I do not have the insurance I will lose all monies paid to date. I also understand that if my roommate cancels and I decide I still wish to go, I will pay the new single rate at the rate of time of changing the booking.
I have been advised of the option to purchase travel protection. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Would you like to accept or decline travel protection? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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If denying the travel insurance, you do not need to add the insurance amount to your total deposit to be paid.

Will you be the only one submitting payments for everyone on your reservation? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Information and Credit Card Information Acknowledgement {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Terms and Conditions

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Electronic Signature Agreement

Terms {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please provide your name and your signature below. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Travels by Charlotte | charlotte@travelsbycharlotte.com | 219-736-0228
 
[Name of Trip]






Thanks for your payment!

Office Only

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Travels by Charlotte Trip Deposit

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Travels by Charlotte Trip Deposit

The purpose of this credit card authorization form is to protect you, our valued clients, as well as Travels By Charlotte from credit card fraud. All information on this form will be kept strictly confidential and encrypted. This form MUST be submitted before any credit card payments for travel on your behalf will be made.

{{ Cognito.resources['order-transaction-details-header'] }}

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Your Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Mobile Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Untitled

Vacation Details

Departure Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Resort Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please select your room type: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Travelers' Information

NAMES MUST BE AS THEY APPEAR ON YOUR PASSPORTS FULL COMPLETE NAME-NO INITIALS

Failure to give proper name will result in denial into your destination which would result in no refunds- read form completely before signing. 
 
If traveling within the USA you do not need to include your passport information unless you will be using your passport as your identification at check in.
(Include all traveling with you as well as yourself. Print names as they appear on passports, If not traveling internationally print names as they appear on Government Issued ID.)
Roommate Information
Traveler # {binding ItemNumber}
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Date of Birth {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Gender {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Nearest Major Airport {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Allergies/Special Accommodations
Please select one or more choices {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please provide any specific allergies or special accommodation needs below: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Emergency Contact Person
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Relationship {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Contact Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Do you currently have a passport with at least 2 blank pages and with an expiration date after (date six months after return date)? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

A passport is required in order to go on this trip. This does not affect your ability to register for this trip at this time so please submit your payment as soon as possible. Just be aware that you are responsible for obtaining a valid passport.

Please either apply for a new passport or renew your passport if it expires after the date given. It takes 4-6 weeks to receive your passport in the mail.

CLICK HERE to begin the process. 

Passport Requirement Acknowledgement {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Untitled
Passport Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Nationality {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Country of Issue {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Expiration Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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  • Spelling of name must be exactly as it appears on your valid passport book.
  • Travels By Charlotte is not responsible for denied boarding if provided with incorrect passenger information or if your passport is expired, not valid or incorrect proof of citizenship.
  • It is the responsibility of the passenger to confirm entry into another country if passport expires in 6 months or less at time of travel or if eligible to travel to all countries that are part of their travel itinerary. This includes any stops in countries which may be part of the “in-transit” itinerary.
  • If you are unsure about your eligibility to travel, including restrictions due to criminal records, child support issues or DUI’s please inform me immediately.
  • All bookings are non-refundable.
  • Any changes to the reservation will result in fees
Passport/Government ID Information & Status Acknowledgement {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

COVID-19 Waiver of Liability and Assumption of Risk

READ THIS DOCUMENT CAREFULLY—IT IS A RELEASE OF YOUR LEGAL RIGHTS.

The novel coronavirus, COVID-19, was declared a worldwide pandemic by the World Health Organization in March 2020. COVID-19 is highly contagious and is believed to spread mainly from person-to-person contact, through respiratory droplets and aerosol transmission. The U.S. State Department raised its global travel warning to the highest level, which recommends that citizens avoid all international travel, and makes clear that repatriation (returning to your home country) may not be provided and travelers may be stuck abroad. Most governments and public health agencies recommend social distancing and have, in many locations, restricted travel and congregations of groups of people. Even those destinations that allow visitors have limited or closed tourist sites and activities, or may do so in the future with no announcement. It is believed that traveling increases the risk of contracting COVID-19 due to decreased social distancing, increased exposure to people who may be contagious, and lack of due care or poor sanitization standards by those around you or suppliers, among other possible reasons.

I acknowledge that I am aware of: (1) the contagious nature of COVID-19; (2) the risk that I and my travel companions may become exposed to and/or infected with COVID-19 before, during, or after travel, which may result in personal injury, financial loss, illness, permanent disability, and/or death; (3) the risk that I and/or my travel companions may become subject to mandatory quarantines or other similar measures and their related costs; and (4) the risk that my travel plans, activities, and plans to return home or to work may become interrupted, delayed, canceled, or otherwise ruined due to COVID-19. I also acknowledge that infection or exposure to COVID-19 may result from the acts, omissions, or negligence of others, including but not limited to travel providers (for example: airlines, hotels, transportation companies, buses, trains, ships, tour guides, tourist site operators, and tour operators), Travels By Charlotte, LLC, my travel companions, and other persons. With full knowledge of these risks, I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury, illness, damage, loss, claim, liability, or expense, of any kind, to myself or the travel companions for whom I book travel, as a result of these risks.

I understand that the destination may require certain protocols to enter into their country and I and/or my travel companions will comply with those requirements.  I and/or my travel companions understand that if we do not comply, this will result in denial into the country, trip cancellation or being quarantined. This will also result in not being refunded for any monies lost or any days missed. 

Travels By Charlotte, LLC., is providing me with its travel planning and booking services. In exchange, I release, promise and covenant not to sue, discharge, indemnify, and hold harmless Travels By Charlotte, LLC., and any of its officers, employees, and agents from any and all liabilities, claims, demands, lawsuits, actions, liabilities, and causes of action, directly or indirectly arising out of or related to any damage, injury, death, or loss that may be sustained by me or those in my traveling party for whom I book travel, related to COVID­19. I acknowledge and agree that I am releasing all claims based on the acts, omissions, or negligence of Travels By Charlotte, LLC., its employees, agents, and representatives to the fullest extent permitted by law.

I HAVE CAREFULLY READ THIS DOCUMENT, I UNDERSTAND WHAT IT MEANS, AND I ACKNOWLEDGE THAT BY SIGNING BELOW, I AM BINDING MYSELF and releasing legal rights for everyone in my travel party.

 

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Travel Protection

I understand that by checking the appropriate box, I am accepting or declining travel insurance for the entire party on this itinerary/form and if we are accepting, the amount is added to the deposit amount that is due. I have been given travel insurance information and I am accepting or declining to purchase with full knowledge of the coverage and have been explained the importance of travel insurance. I understand that if my roommate cancelsand if I do not have the insurance I will lose all monies paid to date. I also understand that if my roommate cancels and I decide I still wish to go, I will pay the new single rate at the rate of time of changing the booking.
I have been advised of the option to purchase travel protection. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Travel Protection Amount {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Will you be the only one submitting payments for everyone on your reservation? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Terms and Conditions

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Electronic Signature Agreement

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Travels by Charlotte | charlotte@travelsbycharlotte.com | 219-736-0228
 
[Name of Trip]






Thanks for your payment!

Office Only

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