(330) 364-5348

Credit Card Authorization Form for Payment Plan

Guest Name:

Additional Guest Names:

Credit Card Holder’s Authorization: In lieu of my credit card imprint, I
Hereby authorize the above travel provider, Infinite Journeys Travel LLC, to charge my credit card the payments as
scheduled below:

Name on Card:

Card Type:

Card Number:

Expiration Date:

Security Code:

Billing Address:

City / State / ZIP:

Phone:

Your Email (required)

Please break up payments into the following schedule (please be advised that ALL scheduled payments must be
completed no later than the Final Payment Due date on your invoice after deposit is applied. You may schedule up
to 2 payments per month on the 1st and the 15th of each month only):

Amount #1

Date to be charged #1

Amount #2

Date to be charged #2

Amount #3

Date to be charged #3

Amount #4

Date to be charged #4

Amount #5

Date to be charged #5

Amount #6

Date to be charged #6

Amount #7

Date to be charged #7

Amount #8

Date to be charged #8

Amount #9

Date to be charged #9

Amount #10

Date to be charged #10

By signing below, I acknowledge and accept the charges described herein and understand that should my travel
plans change, and I did not purchase insurance, I may not be entitled to a full refund and that cancellation or change
fees may apply. If I purchased insurance, my cancellation penalties would be adjusted or waived, based on the terms
of the policy purchased. I accept that Infinite Journeys Travel LLC, it’s travel suppliers and its independent agent
are acting fully upon my direction and that I will not hold them responsible for acts beyond their immediate control
as it relates to this charge and that I will make payments according to the terms of my agreement with the credit card
company.

Signature:

Date:

Additional Message