Travel Direct Corporation
4 Reserve Way
Milford, New Hampshire
Please provide the following information for our records regarding the cruise line processing of your credit card charge. Important: Both pages of this form should be faxed or mailed back to us. Do not e-mail this information.
1. Cardholder’s Name ( first, middle name or initial, last ) [ exactly as it appears on the charge card ]
2. Cardholder’s Address [ The address where you receive your monthly statement and where you want us to send your cruise documents. If you would like documents sent elsewhere or change your address, be sure to let us know. Otherwise your documents will be sent to this address.]
3. Telephone Number: Home ( )_____________Office ( )_________________Mobile( )___________
4. Card Type: Amex___Mastercard____Visa____Discover___( Is this a cash/debit card?__Yes __No
(Note: If this is a cash or debit card, you may have a maximum limit on what can be charged per day.)
5. Card Number:_____________________________________________Expiration Date:____________________
6. Credit Card Verification Value Number:____________Note: The three or four digit Credit Card Verification Value number is located above or below the credit card number or located on the back of the card.
7. PAYMENT: I Authorize Travel Direct Corporation dba Cruise Direct Online to forward to the cruise line my credit card information so the cruise line may process the charge in the amount of $___________________. I further understand that the proof of citizenship/proof of identity, payment requirements, booking conditions and cancellation policies of the Cruise Line and not that of Travel Direct Corporation apply to this transaction.
Please mark all of the following with an "X" in front of the appropriate answer; ( Example: X Yes )
• This payment is for, _____Deposit _____Final Payment.
After being advised I, _____Accept _____Decline cruise line
arranged travel insurance.
11. Cardholder Signature ( Granting Authorization ) ______________________________________Date:______________
[As it exactly appears on the charge card]
12. Please Fill In. Sailing Date_________________ Cruise Ship:__________________Cabin #___________Tour#___________
Note: If a cruise tour, enter (start) date of cruise tour in "sailing date" space above & enter cruise tour # above
13. Passenger Names: Must be listed exactly as they appear on their birth certificate or valid passport. Depending upon your destination (s) an original birth certificate & photo ID or Passport with or without Visas are required. Passports must be good for at least 6 months after trip is completed. It is your responsibility to contact the cruise line for exact citizenship/identity requirements for your sailing. Failure to have the proper citizenship and identity documents may result in denied boarding. If you are denied boarding, you will not get a refund. DOB = Date of Birth
(1)__________________________________ ( DOB ) _______ (2)_________________________________ ( DOB ) _______
(3)__________________________________ ( DOB ) _______ (4)_________________________________ ( DOB ) _______
14. Dining Preference: (On Request Only, subject To confirmation) ____First ____Second _____Open
Note For security reasons, we do not take credit card information over the phone. The credit card information provided by fax, or mail is given directly to the Cruise Line who will process your charges. Their name will appear as the merchant on your monthly card statement. Our Pay Direct Process provides comfort and assurance that your funds are deposited directly with the Cruise Line. Cruise Direct Online aka Travel Direct Corporation is a licensed, bonded Seller of Travel in Florida, Registration # 31254
Important: This notice must be faxed or mailed back to us.
For security and privacy reasons, do not e-mail this information.
Consumer Disclosure Notice
In any business arrangement, even travel, there are certain responsibilities the traveler has in the relationship.
Let’s discuss them. When placing a reservation with us you agree to the following;
You and your travel companions or group members assume complete and full responsibility for, and hereby release us from, any duty of checking and verifying any and all passport, visa, vaccination, or other entry requirements of each destination, and all safety and security conditions of such destinations. You assume full responsibility for verifying you have the correct and valid identification in the form of a valid passport, visa, vaccination, Picture ID or other entry requirements for countries visited on your cruise. You should verify all safety and security conditions to the places you are visiting. You agree that we are not responsible for any potential risks and hazards associated with your cruise. And if there is any political instability, terrorist activity, war, social or labor unrest, a civil disturbance, military activity or emergency evacuation, mechanical or construction failures or difficulties, diseases, local laws, climatic conditions, abnormal conditions or developments, we are not responsible. By going on a cruise booked through us, you and your travel companions or group members voluntarily assume all risks involved in such travel, whether expected or unexpected. When placing a reservation with us, you further understand and agree that;
We are not responsible for overbooking, cancellation or delays for your airline, cruise or cruisetour. You are responsible for any damage to or loss of luggage or personal items. You are responsible for any trip cancellation, trip interruption or delay, medical expense or any emergency evacuation. We recommend the purchase of travel insurance to cover these possibilities. You are responsible for understanding the coverages, monetary limits and restrictions that apply to travel insurance. You have read and understand the general information provided you, how the air/sea program works and how other forms of a reservation work. You have read the cruise line’s brochure and fully understand the cruise lines booking, air/sea program, payment and cancellation policies that apply to your reservation. If you are purchasing a restricted fare of any kind, as an example, a Senior Citizen Rate (1 guest in each stateroom must be 55 or older) or a Resident Rate (1 guest in each stateroom must be a resident of the state), you may be asked to produce proof of age or residency at the pier. If you do not qualify for these fare restrictions or cannot prove it, the cruise line may be collecting the additional fare at the pier.
We provide a travel planning and booking service to you for the cruise lines and other suppliers. We do not control these suppliers, therefore we are not responsible for any action on the part of such suppliers which results in any loss, damage, delay or injury to you or your travel companions or group members. We do not guarantee nor are responsible for any suppliers’ rates, bookings, reservations, travel arrangements, airline or cruise ship schedules. If you have questions regarding our relationship, or need clarification of this information please give us a call. We would be pleased to answer any questions you may have. Please share this information with everyone in your traveling party and sign below. You or your travel companions or group members retention of tickets, reservations, or bookings after issuance shall constitute consent to the above and an agreement on your part that your travel companions or group members have read and understood this important information.
Please return a signed copy of this page to us prior to making a deposit or other payment for your cruise. Thank You.
_______________ _________________ _________ ______________ ____________ _______ _________
Passenger Name Signature Date Cruise Ship Sailing/tour Date Tour # # of Guests in Party