(614) 771-6200
5064 Cemetery Rd. Hilliard, OH 43026
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Credit Card Authorization Form * Required Fields


    
Male   Female 
    




VI   MC  AX  DS 







Passengers Names exactly as appears on Passport* Gender & DOB: (MM/DD/YY)*

Male   Female 
Passengers Names exactly as appears on Passport* Gender & DOB: (MM/DD/YY)*

Male   Female 
Passengers Names exactly as appears on Passport* Gender & DOB: (MM/DD/YY)*

Male   Female 
Passengers Names exactly as appears on Passport* Gender & DOB: (MM/DD/YY)*

Male   Female 

PLEASE READ CAREFULLY BEFORE SUBMITTING

I give full authorization to Active Travel, and/or Classic Vacations to charge the above mentioned amount on my credit card as identified above and shall not decline, reject or challenge such amount charged on my credit card for the purpose of paying for air, cruise/or tour, for the passengers identified above. I also declare that I am aware that some restrictions may apply to the tickets purchased by this transaction and that I am satisfied that such restrictions have been explained to me. By accepting these terms, you are consenting to the supplier's terms and conditions. I have been offered insurance for my travel arrangements.

Yes   No 

I Have Read and Agree to The Terms

**Please note the following**

Passports needed 30 days prior to day of departure

E-mail: activetravel@msn.com

or
Mail to:Active Travel 5064 Cementery Road - Hilliard, OH 43026


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Active Travel
5064 Cemetery Road, Hilliard, OH 43026
Tel. (614) 771-6200 E-mail: activetravel@msn.com