Credit Card Authorization

Magical Treks works hard to secure all information you provide us. Only Magical Treks or its employees will have access to the form below. While we are constructing a secure electronic payment system, we ask that you fax the form below to +1 866-204-8645.

Trip Details

Confirmation Number:

Payment Details

Name as Appears on Card:

Credit Card Type:

VISA

MASTERCARD

AMERICAN EXPRESS

DISCOVER

Card Number:

Card CCV:

Month

Year

Billing Address Line 1:

Billing Address Line 2:

City:

State:

Zip:

Phone Number:

Email Address:

Keep Card on File:

$
Amount to Charge:

I, the above cardholder authorize the above amount to be charged to the above credit card. My signature confirms that I am the above cardholder and that I
acknowledge that payments received by Magical Treks LLC for deposits, final payments, travel insurance, airline tickets or other confirmed services, constitute acceptance of confirmed
services.

I, the above cardholder hearby authorize Magical Treks to keep to keep my card information on file if I have inidcated such on the form above. If in the future I use the “Make a Payment” form, I will indicate this card by supplying the last four digits of the card number as provided above.

I, the above cardholder further acknowledge that upon receipt of this signed and dated Credit Card Authorization form by
Magical Treks LLC, the named travelers are responsible for travel insurance, airline ticket, or other service Terms & Conditions and airfare rules & regulations (as
applicable).

I, the above cardholder understand that failure to have this form properly completed and returned to Magical Treks may result in cancellation of my confirmed services,
and that I will be subject to cancellation penalties that are applicable. I verify that all information on this Credit Card Authorization is correctly provided,
and that I, the above signed, am the cardholder of the above credit card. My signature also implies that I, the above cardholder and/or tour participants
agree not to request any charge backs on the credit card until any disputed matters are resolved with Magical Treks and/or the travel agent that has
undertaken this booking. I further verify that the signature above is my signature as indicated on the reverse of the above-indicated credit card.

Signature:

Date: