Anderson Travel and Tours

Credit Card Authorization Form (Miami 2024 Tour Hotel)

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— Cardholder Details —

Cardholder Name (as shown on card):
Billing Address

— Card Details —

Card Type

— Authorization —

Do you need an Accessible Hotel Room (mobility accessible)?

Fairfield Inn (Bessemer)

4980 Academy Court, Bessemer, AL 35022

Bessemer 2 Nights – (Jan 19-21)
Bessemer 1 Night – (Jan 20-21)
Bessemer 1 Night – (Jan 27-28)

Fairfield Inn (Fultondale)

1795 Morris Ave, Fultondale, AL 350682

Fultondale 2 Nights – (Jan 19-21)
Fultondale 1 Night – (Jan 20-21)
Fultondale 1 Night – (Jan 27-28)

Marriott Bonvoy Account # and other Notes

I authorize ANDERSON TRAVEL AND TOURS for the designated TRAVEL SUPPLIER selected below to charge my credit card above for agreed upon purchases.
I understand and agree on the total package price, destination, itinerary/details and terms/conditions as explained to me by ANDERSON TRAVEL AND TOURS. I understand and agree that ANDERSON TRAVEL AND TOURS is not responsible for any changes, errors, negligence or refund amounts/delays made by the designated TRAVEL SUPPLIERS.
I understand and agree that I am fully responsible for any charge-back dispute and/or non-payment to Credit Card Company or Issuing Financial Institution.
I understand that ANDERSON TRAVEL AND TOURS is not responsible for disputes between me and my credit card company/issuing financial institution regarding charges accrued directly with the TRAVEL SUPPLIER.
Print Name
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