Charge Authorization Form

                       Letter of Authorization to Charge Credit Card


Tour Operator: _________________________________________________________________


___ Yes, I elect to purchase travel insurance with the supplier in the amount of _________.

___ No, I do not elect to purchase travel insurance.


Total price of Vacation: $____________._______.


I authorize the tour operator to charge my c/c in the amount of: $__________.______


Name exactly as it appears on your credit card________________________________________


Cardholder’s Signature: ______________________________________ Date: ____/ ____/ ____


Credit Card Type: ____M/C ____Visa ____American Express ____ Discover


Card Number: ____________________________________exp:_______ Security code: ________


Cardholder’s Billing Address: ____________________________________________________


City: _______________________________________ State:___________ Zip:__________________


Home Telephone: (      ) ____________________    Work Telephone: (       )_____________________


E-Mail address: _______________________________________________ Fax:___________________


Passenger’s Legal Names exactly as they appear on passport and date of birth, Passport #, Expiration Date,

US: Yes/No












Terms and Conditions

We are pleased that you have chosen VIP Leisure Travel to assist you with your travel arrangements. It is our goal to make your vacation as pleasant as possible so that we can count on your continued patronage.


 Documentation:  Passports & visa’s: Securing any needed passports and visa(s) is the responsibility of the participant.  US Citizens.  A valid passport is required for all international travel. Passports to Europe and some other destinations cannot expire within 6 months of the date you return to the U.S.  A U.S. passport is valid for ten years (five years for children). To apply for passports you can contact either your local passport office, designated federal or state clerk of court, or selected post offices. It is the responsibility Non-US citizens to contact their local consulate or embassy before they travel for exact citizenship and visa requirements.  Failure to comply with any of the above will result in denied boarding.   



VIP Leisure Travel and the agents through whom you purchased your travel products are acting merely as agents on behalf of various travel product providers.  It is our aim to provide you with the best quality product in the market place.  However, we cannot bear any responsibility for the fulfillment of the services or promises of the various travel and providers, nor for any loss or damage occasioned by a failure of any travel provider or to perform as promised or to use all reasonable care in the provision of services.  We advise all of our clients to purchase travel insurance to protect against operator default, accidents, sickness, trip cancellation, lost or delayed baggage.

VIP Leisure Travel and its agents are acting as a mere agent for the travel suppliers you are using.  Therefore, VIP Leisure Travel and its agents are not responsible for the deliberate acts, errors or omissions of any supplier.


TRAVELers Protection:  Your vacation should be worry-free. However, we understand that sometimes it is necessary to cancel your vacation because of an illness, injury to you, your immediate family member or a traveling companion, or death in the family. Coverage includes, but is not limited to, medical expenses due to illness or accident, theft, loss, damage or delay of baggage; travel delay; emergency evacuation expenses; and assistance with travel related emergencies. Terms, conditions, exclusions and limitations apply and are detailed with the policy benefits, which will be mailed to you within 7-10 business days after purchase. These non-refundable and non-transferable plans must be purchased at time of booking and paid for when trip deposit is made.  Please be sure to take the policy with you on your vacation.


Cancellation Penalties:  If after making a deposit a cancellation occurs, VIP Leisure Travel will charge a $50.00 cancellation fee per booking to cover the cost of providing vacation services.   

Said fee will be charged to the most recent credit card on file.  In addition to this charge, cancellation penalties by the cruise line or tour operator may also apply.  I waive my right to dispute these charges. 


                          I have read and agree to all of the terms and conditions above.

                          Reservations will not be processed without a signed form.

                          Please return by fax to: 1-757-229-6130


Signature: ___________________________________            Date:___________________________