Payment Authorization

 

    Payment    Authorization

Routes Beyond LLC dba

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21 Franklin Place Maplewood, NJ 07040 +1-973-763-6035  Fax: +1-973-975-0691 Toll free in the US: 1-888-575-6941

 

PLEASE PRINT THIS PAGE OR WE WILL EMAIL IT TO YOU, READ IT CAREFULLY, SIGN AND Email to Info@EgyptMagic.com  or   FAX  TO +1-973-975-0691.

Departure Date and Destination:
Number of Passengers:
Passenger     Information (use second sheet if necessary):                                                                                    Name as on passport                       Nationality                     Passport Number              & Expiry   1. (Primary) 

  2.

  3.

  4.

   Primary address (if credit card payment, must be the billing address for the credit card):   Phone Number:                                        Email: 
Payment     Type:          Wire Trans.        Personal/Business Check         Credit Card (complete box below)

Card Type:               Visa         MasterCard               Discover

Amount Authorized: 
Card     Number:
Expires ______/20______           Card Verification Number:                             
Name of Cardholder:
Billing    Address for Card, if different from above:
Air ticket prices are not    guaranteed until ticketed and may be subject to various restrictions including those    relating to refundability, transferability and penalties for changes.  Any change in    carrier(s), flight(s), time(s) or routing may result in a carrier demanding full fare.      Cancellation and refund policies are established by the airline or other supplier.      All air tickets and other services are issued subject to the contractual conditions    and tariffs imposed by the supplier(s) of the services.  Routes Beyond LLC     acts as agent for the client and/or suppliers of services and assumes no     liability for services, transportation or equipment provided by airlines,     local hotel/dive/tour, car rental companies or other suppliers/operators.     . In the     absence of negligence on our part we are not responsible for their acts or     omissions. We have no special knowledge or information regarding any     supplier insolvency, unsafe conditions, health hazards or weather hazards.     We can assume no responsibility for arrangements made by clients including,     but not limited to, missed connections, incorrect bookings and other     problems. Charges as a result of this authorization may be made by third     parties.Yes/No                  I agree to having credit card charges, as indicated above, applied to the     above credit, debit or other account by the appropriate airline(s) and/or     service provider and agree to be bound by the agreement with the card     issuer.

Yes/No                 I have read, understand and agree with the above, and with the Terms &     Conditions available at http://www.EgyptMagic.com/pa/terms.htm

Yes/No                I understand that Routes Beyond recommends travel insurance for my own     protection and I have reviewed the information provided at http://www.EgyptMagic.com/Insurance     and have decided to or not to purchase.

Yes/No                I understand that I am responsible for all legal country entry and exit     requirements including visa and passports and I agree to reconfirm all     airline flights personally or to be assured by others that they have     reconfirmed.

 

Signature:  X Date:

 

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