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Guest Information
Mr/Ms
*
Given Name
*
Surname
*
Date of Birth
*
+
Mr/Ms
Given Name
Surname
Date of Birth
+
Mr/Ms
Given Name
Surname
Date of Birth
+
Mr/Ms
Given Name
Surname
Date of Birth
+
If sharing a room with any other guests not listed above, please provide their names below:
Email Address
*
Phone Number
*
Travel Information
Departure Airport
*
Arrival Airport
*
Check In Date
*
+
Check Out Date
*
+
Room Category
*
King Bed
Double Beds
Payment Information and Credit Card Authorization
Billing Address
*
Address Line 2
City
*
Province/State
*
Postal Code/Zip Code
*
Name on Card
*
Credit Card Type
*
Visa
MasterCard
American Express
Discover
Credit Card Number
*
Expiration Date (mm/yy)
*
CVV
*
Payment Amount
*
Memo
Once your payment has been processed, Air Canada Vacations will show on your credit card balance. When you are added to the group block, you will receive a confirmation email. Please allow 2 business days for an invoice to be sent.
This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for one time use only. A written notice of rejection or cancellation of these arrangements must be received in writing within the time limits stated in the Terms & Conditions. If not received, no charge-backs or cancellation will then be accepted. Your signature on this charge confirmation form is an acknowledgement that you have received and read the Terms & Conditions and that you understand the Cancellation Policy, I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form. I am aware that deposit payments are 100% non refundable and agree not to dispute or attempt to charge back any of the above signed for and acknowledged charges. *
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