Credit Card Authorization — Getaway and Play Travel

Trip Details

Traveler Name(s)*

Destination*

Travel Dates*

Total Authorized Amount (USD)*

Numbers only, no $ sign

Additional Notes

Optional — any special instructions or notes about this authorization

Cardholder Information

Name on Card*

Billing Address*

City*

State*

ZIP Code*

Phone Number*

Email Address*

Card Details

For your security, please provide only the last 4 digits of your card number.

Card Type*

Last 4 Digits*

Last 4 digits only

Expiration Date*

MM/YY

Authorization Agreement

By completing and submitting this form, I authorize Getaway and Play Travel to charge the credit card listed below for the total amount indicated for travel services rendered.

I understand that this authorization will remain in effect until I notify Getaway and Play Travel in writing to cancel it. I certify that I am an authorized user of this credit card and that I will not dispute the payment, provided the transaction corresponds to the terms indicated in this form.

I agree to pay according to the card issuer agreement. I acknowledge that the origination of this transaction must comply with the provisions of U.S. law.

Signature (type your full name)*

Typing your name serves as your electronic signature

Date*

I have read and agree to the authorization terms above. I authorize Getaway and Play Travel to charge my credit card for the amount specified.

Questions? Reach out to us directly. [email protected]