Kommemorative Vacations Payment Processing Form

Please complete this travel reservation form completely. You must enter your name as it appears (or will appear) on your passport or identification that you will use for travel.

You will receive an email confirmation from us once this form is complete and payment has been processed. If you have any questions while completing this form, please contact us at the telephone number listed below.

Thank you.

First Name *

Middle Name / Initial

Last Name *

Email Address *

Confirm Email Address *

Name as it appears on Credit Card *

Card Holder Telephone Number *

Billing Street Address *

City *

State *

Zip Code *

Credit Card Type *

Credit Card Number *

Expiration Date (MM/YY) *

Security Code (3 digit code found on the back of the card) *

Payment Amount ($XXX.XX) *

Please upload a copy of your valid passport or photo ID.

I hereby authorize my credit card be charged for the amount listed above. I understand that payments are non-transferrable and may be non-refundable depending on the options selected in my vacation package. Additionally, cancellation fees may be charged to my card on file should cancellation occur. Signing and submitting this form means you have read, understood and agreed to the terms of your reservation. This information will be listed in your confirmation email. *

I agree

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