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Egyptian Cruises and Tours
Credit Card Authorization Form
RETURN THIS PAGE FOR DEPOSIT
WE WILL NEED ALL OTHER PRE TOUR
DOCUMENTS AS SOON AS POSSIBLE
Please mark card type:
q AMEX
q
Diner's Club
q Discover
q
MasterCard
q Visa
Name as it appears on card:
________________________________________________________________________________
Card # :
_______________________________________________________________Card
Expiration Date: ______________
4 digit security code for AMEX (on front of
card) or 3 digit CID for other cards
(located on back of card) REQUIRED:
______
Billing Address:
________________________________________________________________________________________
City:_________________________________________
State: _____________ Zip Code:
___________________________
Please check the applicable boxes and
complete each line with the amounts per
person and total up each line:
Deposit - Double Occupancy:
Egypt Revealed: $1567 x 2 =
$3134. Egypt Revealed & Petra: $2036 x 2 = $4072
Deposit
Single Occupancy: Egypt Revealed: $2419.
Egypt Revealed & Petra $3033
q
Deposit
Payment
$_________________ X number of
persons ________ = ______________
q
Final Payment
(due 120 days prior to departure)
$_________________ X number of
persons ________ = ______________
q
Full
Payment
$_________________ X number of
persons ________ = ______________
Total Tour Charge (excludes trip
insurance) = ______________
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Ker & Downey offers Access America
Travel Insurance. Initial below and
complete the fields if you wish to
purchase. A separate charge
to Access America will appear on
your monthly statement. For more
information contact your travel
consultant or agent. You can also
purchase online at
www.kerdowney.com and click
on the insurance button.
Please Initial: _____ I accept
_____ I decline
q
Insurance per
person
$________________ X number of
persons ______ = ______________
Notes regarding Access America
travel insurance: Insurance premium
is non-refundable. The policy
exclusion for pre-existing
conditions will be waived provided
that 1)trip is insured within 14
days of initial trip deposit,
2)client is medically able to travel
at time of insurance purchase,
3)client has not filed a claim for
trip cancellation due to a
pre-existing condition within the
last 120 days from the effective
date of insurance, 4)Client's trip
cost is $50,000 or less per covered
person, and 5)client is a resident
of the United States |
Cardholder's Information and Signature
Notwithstanding anything contained in your
Cardholder Agreement with the provider that
is to the contrary, written notice of
rejection or cancellation of these
arrangements must be received in writing by
post or by facsimile transmission within the
time limits stated in the Ker & Downey Terms
& Conditions of Business. If not received,
no charge-backs or cancellation will then be
accepted. Your signature on this Charge
Confirmation is an acknowledgement that you
have received and read Ker & Downey's Terms
& Conditions of Business which detail this
company's policies on payments,
cancellations and refunds for the travel
arrangements you have made. You should
review Ker & Downey’s Terms & Conditions of
Business and this document thoroughly before
signing to finalize any travel arrangements.
Cancellation:
121 days or more
prior to departure-$750 per person; if cancelled prior to 121 days
and the booking is sold to another Brown and Keene client the
penalty will be waived. 120-46 days prior to departure-35% of tour
cost; 45-31 days prior to departure-75% of tour cost; 30 days or
less prior to departure-100% of tour cost to include handling fee
and liquidated damages for KDH. Additional cancellation penalties
may apply to air arrangements
By signing below you acknowledge and confirm
Ker & Downey Terms & Conditions and this
charge authorization.
Print Name: ____________________________
Signature: _______________________________
Date: _________
Tel (day):
____________________________________ Tel
(evening):
___________________________________
Agent Code BRO001
Travel Date: 03/20/10
Booking Ref KHFI105099
Consultant Kim Cooper
Booking Name Brown and Keene Eg
Return this page with all other pre tour
documents to 281 371 2514
Ker & Downey, 6703 Highway Blvd., Katy, TX
77494
Direct: 281-371-2500 - Toll Free:
800-423-4236 - Fax: 281-371-2514 - info@kerdowney.com
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www.kerdowney.com
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