Surreal Journeys Travel Client, your trip is approaching!
Travel Date

01/01/2030

 
Trip Total Amount

$

It's time to submit a payment.

With your trip date approaching, please use the form below to submit your payment information.
Please let me know if you have any questions.

Amount Due

$

Pay By

Thank you for choosing Surreal Journeys Travel. Please disregard "Trip Date" displayed. If you do NOT know your reservation number, please notate the destination you are paying for. Please allow up to 2 business days for payment to be processed.




Credit Card Information

Credit Card Expiration Date

Billing Information


Consent

By completing this form, I, the individual identified in the credit card information section above, authorize the agent or agency providing this form on this website or by email, or their authorized representative, to charge my credit card listed on this document for reservation for the trip departing on 01/01/2030. I understand all the terms and conditions of this booking and agree to the terms and conditions made available to me for this travel arrangement, including all cancellation policies. I understand and agree that travel arrangements may be subject to non-refundable cancellation penalties. I agree to carefully read all emailed communication between and myself and note all restrictions that may apply. I further understand that as part of your travel services, you recommend that all travelers purchase some form of travel insurance to help protect their travel investment. I, the above-named Cardholder or authorized representative, certify that the information provided on this form is true and correct. I am authorized to effect charges on the credit card number provided. I agree that in the event of a discrepancy to my credit card account, I will notify your agency's accounting department within seven (7) business days of receiving the credit card statement or immediately upon knowledge of such error.

If you are using a debit card with a daily spending limit, it is your responsibility to contact your bank to give them permission to authorize the transaction. If they require the name of the vendor and you are unsure as to who that is, please contact surrealjourneystravel@gmail.com.


Verbal Approval Authorization


Electronic Consent

We use electronic documents to obtain consent and to notify you of important information regarding your transactions with us. Please check the box below to agree to electronic communications per our terms and conditions and privacy policies. Otherwise, please call us at the number at the top of the page.

Please charge my credit card referenced above in the amount indicated above for reservation # for the trip departing on 01/01/2030. I understand all of the terms and conditions regarding this booking including cancellation policies, applicable penalties, and the availability of travel insurance.


If you are using a debit card with a daily spending limit, it is your responsibility to contact your bank to give them permission to authorize the transaction. If they require the name of the vendor and you are unsure as to who that is, please contact Surrealjourneystravel@gmail.com.


Surreal Journeys Travel, LLC


757.529.1187
Surrealjourneystravel@gmail.com