Make a Payment

To make a payment, you must first verify the information related to your payment and accept the terms of our travel agreement. To verify your information and accept our terms, please fill out the form below. To avoid large transactions fees and save you money, we take credit card information by phone. Once you’ve verified your info and accepted the terms, please call your travel consultant to make your payment.

Name

First Name

Last Name

Dates of Travel

From

MM

DD

YYYY

To

MM

DD

YYYY

Name on Card

Billing Address

Last 4 digits of Credit Card and Expiration Date

Payment Amount

$

Travel Insurance

I wish to purchase travel insurance

I decline to purchase travel insurance

Travel Agreement

I have read and do accept the terms of the travel agreement

Itinerary Confirmation

I have looked over the full itinerary for accuracy and verify all components are correct, such as travelers included, travelers birthdays and spelling of names on travel documents, dates and flight times of travel, and resort and room category chosen.

Digital Signature

By checking this box, I hereby digitally sign this form and agree to the terms within. I also grant permission for Citizen Chic to make a payment on my behalf for the amount detailed in this form.

Agent Name

Travel Agreement

I hereby verify that I have reviewed my travel itinerary for accuracy. I have been advised of all applicable fees by Citizen Chic Travel and the suppliers. I understand that Citizen Chic Travel offers retail services to offers retail travel services to customers, which are provided by separate and independent vendors of travel services. Citizen Chic Travel does not operate, control, or otherwise provide the services of the independent travel vendors. Hence, customer agrees that Citizen Chic Travel acts only as agent for the client in acquiring transportation, hotel accommodations, sightseeing and other privileges, or services for the clients’ benefit, and on the express condition that Citizen Chic Travel shall not be responsible for any loss, accident, injury, delay, defect, omission or irregularity which may occur or be occasioned, whether by reason of any act, negligence or default of any company or person engaged in or responsible for carrying out any of the arrangements, or otherwise in connection therewith

I have been offered the option of purchasing trip cancellation insurance. I understand that fares and vacation packages typically involve restrictions and that changing any aspect of my travel arrangements may result in the payment of additional money or loss of funds invested.

DOCUMENTATION: U.S. citizens travelling to any destination outside of the United States will be required to present a valid U.S. passport. Passports must be valid for 6 months past the return date. Some countries require a visa for transit or entry. Passengers are responsible to ensure that they have all the proper documents for entry. All names on documents must match the legal name on your photo I.D., and travel document information must match tickets. Please check the State Department website at https://travel.state.gov for further information. Immunizations may also be required. Failure to comply with these regulations may result in denied boarding, denied entry, and/or government imposed fines. If you are a citizen of another country, there may be additional requirements. Check with the nearest consulate or embassy of the destination you are travelling to and find out the entry requirements for non-U.S. citizens.