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Please
print this form!
Fill out the form below and fax to
(714) 821-3252 to complete your booking. Upon receipt of your fax, we will
mail you a written confirmation.
Credit Card Authorization Form
I authorize La Palma Travel (parent company of Honeymoon Travel)
or the Tour Company used by La Palma Travel, to charge my credit card for
the DEPOSIT or FINAL (please circle one) payment of my vacation package in
the total amount of $__________________________
Please print below passenger legal names (exactly as they appear on Passport
or Birth Certificate):
1)____________________________________________
2)______________________________________
Per Person Rate (without
insurance):_______________________________________________
Description of
Charge:__________________________________________________________
Resort:________________________________ Room
Category:_________________________
Date you arrive at the resort
(mm/dd/yy):__________________ Number of Nights:____________
Air City (if vacation package includes
airfare):_________________________________________
Travel insurance is available from Travel Guard
International ® to protect you financially if your trip is cancelled,
interrupted or delayed. See bottom of form for description.
_______Initial here to
receive further travel insurance information, or here_________ to decline.
________ Initial here to indicate that
you understand and accept attached terms and conditions.
________ Initial here if you want La
Palma Travel to automatically charge the same credit card for final payment,
50 days prior to departure. This can help you avoid a $25 per person late
fee if we do not receive final payment at least 50 days prior to your
departure date.
Credit Card Type: (please circle)
VISA, MasterCard, American Express, Discover
Cardholder's Name (as it appears on
card):__________________________________________
Card
Number:_____________________________________________ Exp. Date:___________
Cardholder's
Signature:_____________________________________ Date:________________
Cardholders Billing
Address:_____________________________________________________
_____________________________________________________________________________________
Day telephone:_________________________ Evening
telephone:________________________
La Palma Travel/ Honeymoon Travel
Terms and Conditions
The terms and conditions below are the
sole contract between La Palma Travel (hereinafter referred to as LPT), the
parent company of Honeymoon Travel, located at 4171 Ball Road, Cypress
California 90630 and the vacation travel participant(s). Payments for air
passage and / or vacation packages are accepted by LPT only with the
understanding that the participant(s) has been made aware of, and agrees to
all terms and conditions of this agreement prior to sending LPT such
payments.
REQUIRED TRAVEL DOCUMENTATION
Travel to the Caribbean requires U.S. citizens
to carry proof of citizenship. Acceptable documents include: (1) A passport
or (2) An original or notarized birth certificate, plus a photo ID such as
your driver's license. It is however, the sole responsibility of each travel
participant to research and obtain any required documentation for their
foreign nation trip. Passengers denied boarding because of improper
documentation will receive no refund.
CHANGE AND CANCELLATION FEES
La Palma Travel charges a minimum fee of $100
U.S. per person, for changes or cancellations to your vacation package.
This charge is in addition to any fee or penalty that may be charged to
you by the airline, hotel and/or tour companies used by La Palma Travel for
your vacation package.
FINAL
PAYMENT: We must receive your final payment
at least 50 days prior to your vacation departure date, otherwise a $25 per
person late fee will be added to the balance due.
TRAVEL INSURANCE
(Optional, but recommended)
Travel insurance provides you with financial
protection if your trip is cancelled,
interrupted or delayed due to certain qualifying events.
Travel insurance costs extra, but can provide peace of mind.
La Palma Travel can provide you with an insurance application or additional
travel insurance information upon request. Many different kinds of travel
insurance policies are available from different insurance companies (none
affiliated with La Palma Travel). La Palma Travel recommends that the
vacation participant(s) consider the Trip Purchase Protection insurance
offered by Travel Guard International ®, a leading company in the field.
Below is a brief summary of the financial protection
provided by Travel Guard International ® if
your trip is cancelled, interrupted or delayed for reasons, such as:
Sickness, injury or death affecting you, your
family members or your traveling companion.
- Financial default of airline, cruise line or tour operator resulting
in the complete cessation of services or filing of bankruptcy. Excluded
is the organization from which you purchased this coverage.
Unforeseen circumstances, such as:* Inclement weather* Termination of employment or layoff affecting you or
your traveling companion. Must have been with that same employer for at
least 5 continuous years.* Acts of Terrorism.* Organized labor strike that affects public
transportation.
Excluded are carrier-caused delays or cancellations, personal financial
circumstances, business or contractual obligations, government regulations,
or change of plans.
- TRIP CANCELLATION
- reimburses your pre-paid non-refundable
cancellation charges for covered reasons, up to the amount of coverage
purchased.
- TRIP INTERRUPTION
- reimburses your
pre-paid unused, non-refundable portion of your trip payment, plus the
cost of returning home, up to the amount of coverage purchased.
- TRIP DELAY
- reimburses you up to $200 a day to a total
of $600 for reasonable additional accommodations and traveling expenses
until travel is possible, if your trip is delayed more than 6 hours.
Payable for only one delay for all insured's. Receipts required for
proof of loss. Included are carrier-caused delays.
- BAGGAGE PROTECTION
- 24-HOUR EMERGENCY HOTLINE
- MEDICAL PROTECTION (sickness and injury)
- $10,000 Medical Expense Benefit - pays any medical
expenses within one year of any injury or sickness
occurring on your trip provided initial treatment was received
during the trip. Medical and surgical treatment by
a licensed physician; professional nursing, hospital, x-ray and
ambulance services and prosthetic devices. Emergency dental
treatment by a licensed dentist only during your trip.
- $20,000 Emergency Medical Transportation Benefit - pays
for transportation ordered by a doctor to the nearest
adequate medical facility.
* Pays airfare from that facility to your return destination within
one year from original completion date.* Pays up to $5,000 for special medical escort
if recommended in writing by a doctor.
- $25,000 Accidental Death/Dismemberment Benefit - pays for
loss of life or limb within 365 days resulting from an accident
during your trip.
This is a brief description of the Travel Guard International ®coverages.
Insurance terms and conditions subject to change. La Palma Travel can mail
you an insurance application that contains insurance rates and further
details upon request. You complete the application, attach payment and mail
it to Travel Guard. A policy describing all coverages in detail will be
mailed to you by Travel Guard Ò upon receipt of
application and payment. Note: La Palma Travel is not affiliated with Travel
Guard International ®.
FINAL PAYMENT: We must receive your final
payment at least 50 days prior to your vacation departure date, otherwise a
$25 per person late fee will be added to the balance due.
By signing below you certify that you have read, and agree to abide by,
all of the terms and conditions contained in this agreement. All
reservations must have this signed form faxed to:
La Palma
Travel / Honeymoon Travel
4171 Ball Road, Cypress, California 90630
voice: 800-314-8800
Fax Number: (714) 821-3252
Signature:_____________________________________________
Date:_________________
