Welcome to Equinox Travel Adventures

Equinox Travel Adventures

Equinox Travel Adventures 258 East 78 Street Suite 4D New York , NY – 10021 Ph: 646 509 7562
Fax: 212 000 0000

PLEASE FILL THE FORM AND ATTACH CLEAR ENLARGED COPIES OF THE FOLLOWING

CREDIT CARD - CLEAR COPY OF FRONT & BACK

VALID PHOTO ID FOR VERIFICATION

SIGNED APPROVED TRAVEL ITINERARY

In lieu of my Credit Card, I ___________________________________________

Hereby authorize Equinox Travel Adventures or it's suppliers to charge my Credit Card. By signing this form I agree to use the services of Equinox Travel Adventures and will not dispute this charge or send a charge back. Equinox Travel Adventures acts solely as Sales Agents for travel suppliers and is not liable for the actions & inactions of such suppliers.

* Required Information

Credit Card Type / Number: *
Expiry date: *
3/4 Digit security code: *
My Billing Address:*
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City
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I authorize the amount of USD :
My Issuing bank :
Telephone number :
Payment for traveler/s name:
Payment for Tour code /name:
Payment for air travel itinerary:
Travel Insurance Accepted:	Yes Decline
Phone :	Home : Office:
Fax :	Home : Office:
Email : *

By signing below, I acknowledge charges for all travel services made through Equinox Travel Adventures . Payment in full to be made when billed or in extended payments in accordance with standard policy of company issuing card. I am also aware of the airline applicable restrictions and / or penalties. Tickets are non-refundable, a service fees applies on tickets issued. Please note there may be no fare, higher fare or lower fare printed on the ticket. Equinox Travel Adventures do es not accept responsibility for any kind of travel documentations (Visas & Passports). In the event of ticket/s lost in the mail, a reissue fee will apply. Overnight delivery is recommended. It is highly recommended that passengers purchase Travel Insurance. We are not responsible for any discrepancies i.e. Hotel description/rating/pricing or inaccurate photos published on web sites. All our Air and Hotel Packages are Non-Refundable, Non-Transferable and Changes are Not Allowed.

AUTHORIZED SIGNATURE: _____________________ DATE: ________