Credit Card Authorization / Payment Form

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Step 1: Trip Details

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Travel Event:
Notes To Agent:
(Bride/Groom name, honeymoon/vacation destination, special requests, or other info to help your agent book your trip)
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Step 2: Payment Details

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Credit Card Type:
Name On Card:
Credit Card #:
Expiration Date:
v
/
v
Security Code:
Billing Address:
Billing City:
Billing State:
v
Billing Zip Code:
Phone Number Of Card Holder:
Email Address Of Card Holder:
Next

Step 3: Payment Amounts

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The final payment date is listed in your quote or on the wedding website. Please be sure to have your trip paid in full before the final payment date. Payments will be made on or after your specified date.
Payment Amount #1
on
xv
Payment Amount #2
on
xv
Payment Amount #3
on
xv
Payment Amount #4
on
xv
Payment Amount #5
on
xv
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Step 4: Payment Authorization

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By initialing below and clicking the “Submit” button, I hereby confirm that by submitting this request, I
am requesting that Romance Travel Group make this travel reservation and payment/s on my behalf. I accept that Romance Travel Group is acting as a mere agent for suppliers in selling travel-related services, or in accepting reservations or bookings for services that are not directly owned or operated by them. I confirm that Romance Travel Group is acting fully upon my direction and requests and I will not hold Romance Travel Group responsible for acts or omissions of the Travel Suppliers or their failure to provide services.
understand that per the Refund Policy, all payments may be non-refundable and as such waive any right to dispute or chargeback any and all payments in case of cancellation.
acknowledge that I have read and accept the Terms & Conditions.
Full Name:
Signature:
I Agree - Submit Payment

Step 5: Thank you!

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Credit Card Authorization / Payment Form - Successful

Thank you! We have received your payment.

All payments are processed manually. Once your payment has been processed, you will receive an email confirmation outlining the details of your booking. If there are any questions, your travel agent will contact you to discuss.

Thank you again! We appreciate your business!