Name As It Appears On Card *

Address *

City *

State *

Postal code *

Email *

Phone *

Date of birth *

TRAVEL PURCHASE AUTHORIZATION. Thank you for your purchase. TAWShauna.com is pleased to confirm the following travel arrangements. To complete your transaction and confirm your arrangements, your signature on this authorization is required.. Charges are payable ONLY to the hotel, resort, tour operator, cruise line or other travel supplier. Independent Travel Advisors may not accept and process charges through any other account, or accept checks, cash or other forms of payment

TRAVEL INSURANCE WAIVER

For your protection, Travel Insurance is strongly recommended and available upon request from. You can enroll online for travel protection for Medical Expenses, Baggage Delays/Loss, Trip Delay or Cancellation, and other coverage, or your TAWShauna.com Independent Travel Advisor can arrange coverage for you. To decline recommended travel insurance, your signature on this insurance waiver form is required. Final Travel Documents (tickets, vouchers, etc.) cannot be sent to you prior to receipt of the signed insurance waiver.

Accept or Decline Insurance *

Decine

I accept or decline travel insurance as indicated above. *

Independent Travel Advisors may not accept and process charges through any other account, or accept checks, cash or other forms of payment.

I authorize InteleTravel.com, this travel supplier and/or Shauna Adams to charge my credit card for the authorized amount below.

Please choose one *

Yes

Credit Card Number *

EXP *

CVV *

Amount to charge *

I have ACCEPTED and AUTHORIZED the travel purchases above, including travel insurance, and I am aware the insurance premium is not refundable.

I also acknowledge that I have read/reviewed my quote and if I must cancel my trip, I may receive a travel voucher and not a cash refund, minus the insurance premium, depending on the vendor being utilized to book my accommodations.

Signature *

Clear

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

For me to help you :). For my use and notes only

Booking Number
Departure Date
Vendor
Additional Traveler Covered

All rates subject to restrictions, availability and change. See www.InteleTravel.com for complete terms and conditions.InteleTravel.com is registered with the States of Florida (ST-32452), Washington (602-735-106), California (209-1941-40), Iowa (977), and Hawaii (TAR 6732) as a seller of travel. InteleTravel.com uses the personal data you disclose about yourself on this form only for the purpose of processing your requested travel purchase. We retain your personally identifiable data only as long as that processing requires. We do not share any of your personal data with any third party except for the purpose of completing your purchase, and then only with third-party travel providers and credit card processors who protect and only process your personal data for the limited purpose of this travel purchase. Following the completion of your travel that is the subject of this transaction, your personal information shall be securely destroyed unless InteleTravel.com is required by law to retain it, and then it will be retained only for that limited legally required purpose. For complete details regarding the protection of your personal information, please see InteleTravel.com’s Privacy Policy posted at