Please sign and complete this form to authorize The Curated Travel Collection/Ears of Experience to charge your credit card listed below for vacation deposit and other indicated services.

By signing this form, you give us permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction for your vacation package deposit paid directly to the travel supplier.

If indicated, your card will also be processed directly to The Curated Travel Collection/Ears of Experience for the amount of the planning package that you choose. It does not provide authorization for any additional unrelated debits or credits to your account unless indicated below.

Please complete all fields. You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.

Please read our Terms and Conditions

*

I agree to the Terms and Conditions

Client Information

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Please list the legal name and birthday with year of each traveler (this is for your reservation as well as travel insurance purposes which is age-based) *

I would like a travel insurance quote. *

Yes

No, I am declining travel insurance

I have a passport that is valid 6 months post travel. *

Domestic Travel and not needed

Yes

No, but I will by time of travel

Payment Information

Name on Card *

Credit Card Type *

Credit Card Number *

CVV Code *

Expiration Date (mm/yy) *

Amount to be charged. *

Date of Payment * +

Description of Goods and Services. *

Name of my Travel Advisor *

Sign Here *

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VACATION DESIGN PACKAGES

Vacation by Design $50 (can be applied to personalize your vacation)

I research and recommendation up to three options that best suits your family's desires. Once we find the perfect fit, I assist with booking your top resort, cruise, or vacation package.

All Design Packages are nonrefundable and good for up to one vacation , per reservation and booked up to six months after purchasing. Only one date change per design package. Anything beyond six months or more than one date change will require purchase of new package at current pricing. *

I authorize you to charge my credit card $50 to Curate My Vacation

Personalize My Vacation

Let me be your personal concierge so that you have more time for making memories. I can assist with all the extras including transfers, excursions, city guides, a day-by-day itinerary and special requests*.

*Pricing is based on the destination/complexity and is per reservation starting at:

$250 Continental United States

$300 Hawaii

$350 Mexico/Caribbean

$400 Europe

$500 Concierge for any destination that does not include booking of resort stay or assistance with a group of 10 or more for any destination/cruise

All Personalized Packages are nonrefundable and good for up to one vacation booking up to one year after purchasing. Only one date change per design package. Anything beyond one year or more than one date change will require purchase of new package at current pricing. *

I also authorize you to charge my credit card $200 to personalize my Continental US vacation

I also authorize you to charge my credit card $250 to personalize my Hawaiian Vacation

I also authorize you to charge my credit card $300 to personalize my Mexican/Caribbean vacation

I also authorize you to charge my credit card $350 to personalization my European vacation

I authorize you to charge my credit card $500 for Concierge services/ My group of 10 or more

I authorize you to charge my credit card $100 for travel within one month

I love to plan and am fine taking care of the extras myself but will let you know if I would like to upgrade.

Credit Card Authorization *

I authorize the above-named agent with Curated Travel Collection to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for one time use only for vacation deposit made directly to the supplier as well as a design fee and planning package paid directly to Curated Travel Collection if so indicated. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form.

Future Transactions *

I understand that my credit card information will be saved on file for future transactions on my account. This card may also be used for additional payments for items marked below, but only when written instruction to use the "card on file" for payment is given to Becky Keenan with Curated Travel Collection.