TRIP REGISTRATION & AUTHORIZATION TO CHARGE TRAVEL SERVICES TO CREDIT CARD by Spiced Destinations

We thank you for choosing Spiced Destinations Inc. Your services / tickets you purchased are based on a pre-paid arrangement; therefore, to process and expedite the issuance of documents and/or ticket(s), please complete the information listed below.

We also require your signature along with a clear photocopy of your passport or driving license (of card holder) showing your name details and the page bearing your signature as acknowledgement and acceptance of the charge and of the cancellation/change penalties, as listed below.

Please note that completing this form will not result in an automatic charge to your card. This is an authorization only.

Card Holder Information

First Name *

Last Name *

Credit Card Billing Street Address: *

Address Line 2 (Suite, Apt, Fl, etc.)

City *

State/Province/Region *

Zip/Postal Code *

Telephone number associated with this card:

Country *

Trip Information

I am travelling to (please list countries of destination): *

Month and Year of trip: (MM/YY) *

Total number of travelers in my party (covered by the same form of payment): *

My Travel Agent Name is: *

Payment and Credit Card Information

Authorized amount to be charged TODAY, in USD: *

Name on Card *

Credit Card Number *

Expiration Date (mm/yy) *

Security Code (CVV): *

Spiced Destinations - Terms & Conditions

Click here for Spiced Destinations Terms and Conditions

Acknowledgment

I hereby acknowledge and authorize Spiced Destinations, to charge the credit card listed below for services/documents to be issued for my travel arrangements.

I am aware of all cancellation policies and should I cancel within the penalty period, my credit card will be credited LESS the applicable penalties/fees.

I also acknowledge that the ticket(s)/package are not transferable. Also, I am aware that some of the authorized funds may be charged directly by the Airline(s) for tickets included in my trip & that charges will be billed to my Credit Card in the name of Spiced Destinations & the Airlines used, not of my Travel Agency.

I acknowledge that I have read and agree to the official Spiced Destinations Terms and Conditions as listed on the above provided link. *

Yes

I acknowledge the specific penalties and cancellations fees as stipulated on the proposal or confirmation of my trip, issued by Spiced Destinations. *

Yes

I acknowledge that Travel Insurance is highly recommended. *

Yes

Please sign below, using your mouse or finger in case you have a "touch screen" *

clear

Travelers Information

Please make sure to complete the following travelers' information section in the most accurate fashion.

Names and dates MUST match the information as it appears your passport.

Failure to do so may result major issues at the time of travel including denial to board flights as well as cancellation of other services. New tickets may be required to be issued on your own expense.

Please initial here: *

Traveler 1

Information below MUST match your passport.

Last Name *

First Name *

Middle Name (if appears on the passport):

Date of Birth (MM/DD/YYYY): *

Street Address *

Address Line 2

City *

State/Province/Region *

Zip/Postal Code *

Phone Number for trip related information and Text Alerts from Airlines and service providers (when applicable) *

Country *

Email Address for Travel Notifications by Airlines and service providers: *

Nationality: *

Passport Number:

Passport Expiration Date (MM/DD/YYYY):

Dietary Restrictions:

Is there a second traveler? *

Yes