Vacation Payment FormCustomer's Name (or person you are paying for)Reservation # (on your invoice)Booking TO #Air, Resort or Cruise ShipDate of TravelPayment InformationName on Credit Card *AddressAddress CityStateZip CodeEmailPhone Number Amount to charge credit cardCredit Card Type- Select -VisaMaster CardAmerican ExpressDiscoverCredit Card Number Expiration Date (mm/yy) CIDPlease add the travel protect insurance in the amount stated on my invoice per person if I have notpreviously purchased it.Leisure Care Land (For Land)Leisure Care Classic (For Cruises) Yes NoAdditional Personal InformationYour Name as it exactly as reads on your Passport Date of Birth Gender Male FemaleCommentsSubmit Form
