Anderson Travel and Tours

Custom Hotel Registration and Credit Card Authorization Form

Cardholder Name (as shown on card):

— Cardholder Details —

Billing Address

— Card Details —

Card Type

GUEST INFORMATION

GUEST FULL NAME (as it appears on the ID you will use at check-in):
List phone you will have with you during the trip.
Home Address
Home Address (if different than billing address)- skip if it's the same
Select Trip:
Select Total to Charge Credit Card for Hilton:
Select Travel Insurance

________________________________

AUTHORIZATION to Charge Credit Card

I authorize ANDERSON TRAVEL AND TOURS for the designated TRAVEL SUPPLIERS 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, omissions, negligence or refund amounts/delays made by the designated TRAVEL SUPPLIERS.
I understand and agree that it is my responsibility to have the proper identification documents for my trip.
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 any TRAVEL SUPPLIER.
I understand that ANDERSON TRAVEL AND TOURS is not responsible for filing travel insurance claims or handling disputes between me and a travel insurance SUPPLIER. All insurance claims must be made directly with the TRAVEL SUPPLIER.
Electronic Signature Agreement:
Date
Electronic Signature – Name

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