Reservation Request/Deposit Form

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Step 1: Number Of Travelers

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Total number of travelers sharing this room:
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Step 2: Traveler Details

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Enter the information for each traveler, making sure the names you enter exactly match what is listed on the passport.

Traveler #1 (Lead Traveler)
First Name
Middle Name
Last Name
Email Address
Mobile Phone
Date Of Birth
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/
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Gender
Traveler #2
First Name
Middle Name
Last Name
Email Address
Mobile Phone
Date Of Birth
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v
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v
Gender
Traveler #3
First Name
Middle Name
Last Name
Email Address
Mobile Phone
Date Of Birth
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/
v
/
v
Gender
Traveler #4
First Name
Middle Name
Last Name
Email Address
Mobile Phone
Date Of Birth
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v
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v
Gender
Traveler #5
First Name
Middle Name
Last Name
Email Address
Mobile Phone
Date Of Birth
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v
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Gender
Traveler #6
First Name
Middle Name
Last Name
Email Address
Mobile Phone
Date Of Birth
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v
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Gender
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Step 3: Trip Details

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Travel Event:
Notes To Agent:
(Bride/Groom name, honeymoon description, vacation destination, other info to help your agent book your trip)
Check-in Date:
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Check-out Date:
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Room Category Name:
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Step 4: Travel Insurance

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Travel Insurance is available and highly recommended to protect your investment. Per the Refund Policy, all payments are non-refundable. If you wish to have coverage for things such as cancellations, medical, lost luggage, trip delay, interruption or evacuation, please consult with and purchase a policy directly from Travel Guard, Allianz or another travel insurance provider of your choice. There are often several different insurance options for you to choose from. "Cancel for any reason" or “cancel anytime” may be an option you can add to the policy. If you do not have "cancel for any reason" or “cancel anytime” added, you can file a claim for covered reasons only. If you choose to forgo travel insurance, you are assuming any and all financial loss associated with your travel arrangements and waive any right to dispute or chargeback any and all payments in case of cancellation or loss.
I, 
confirm that I understand if I wish to add travel insurance to my trip, it is my responsibility to do so by contacting Travel Guard, Allianz or another travel insurance provider of my choice. Furthermore, I accept full responsibility for any and all fees if a cancellation, interruption, delay or additional expense occurs, no matter what the reason is. Per the Refund Policy, I understand that there will be no refunds should I cancel and furthermore, I waive any right to dispute or chargeback any and all payments.
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Step 5: Payment Details

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Credit Card Type:
Name On Card:
Credit Card #:
Expiration Date:
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v
Security Code:
Billing Address:
Billing City:
Billing State:
v
Billing Zip Code:
Phone Number Of Card Holder:
Email Address Of Card Holder:
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Step 6: 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. We can process 1 payment per month until the final payment date. Payments will be made on or after your specified date.
Payment Amount #1
on
Initial Deposit Required

Payment Amount #2
on
v
(Optional)

Payment Amount #3
on
v
(Optional)

Payment Amount #4
on
v
(Optional)

Payment Amount #5
on
v
(Optional)

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Step 7: Payment Authorization

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By initialing and signing below and clicking the “Submit” button, I hereby confirm that by submitting this request, I
am requesting that Chic Romance Travel make this travel reservation and payment/s on my behalf. I accept that Chic Romance Travel 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 Chic Romance Travel is acting fully upon my direction and requests and I will not hold Chic Romance Travel responsible for acts or omissions of the Travel Suppliers or their failure to provide services.
understand that per the Refund Policy, all payments are non-refundable if I declined Cancel Insurance, 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:
Submit Reservation Request

Step 8: Thank you!

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<p>Thank you! We have received your reservation request.</p><p>All reservations and payments are processed manually. Your agent will review your request and confirm pricing and availability. If there are any questions, your travel agent will contact you to discuss before making the reservation. Once your reservation and payment has been processed, you will receive an email confirmation outlining the details of your booking.</p><p>Thank you again! We appreciate your business!</p>