OnlinePaymentCCForm

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AUTHORIZATION

Thank you for booking your upcoming vacation with us!

For your convenience, you may charge vacation payments to your credit card by completing this secure Credit Card Authorization Form. If you wish to give your credit card information over the phone, please complete this form including just the last 4 digits of your credit card and contact your agent with the complete card number. Vacation payments are also accepted by check or money order, made payable to Go Away Groups.

If paying by check or money order, please remit payments to:

Go Away Groups

2977 Highway K #277

O’Fallon, MO 63366

Fax 1.888.989.9027 (toll free)

CREDIT CARD AUTHORIZATION FORM

I, , hereby authorize Go Away Groups or their representative Tour Operator or Cruise Line to charge the following:

Card Type:

Card Number:

Expiration:

Card ID/Security Code:

Visa, Mastercard, Discover - 3-digit, non-embossed number printed on the signature panel on the back of the card immediately following the Visa card account number.

American Express - 4 digit, non-embossed number printed above your account number on the face of your card.

in the amount of:

on Confirmation #:

Credit Card Billing Street Address:

City:

State:

Zip Code:

Contact Phone:

Your Email Address:

SUBMIT PAYMENT

By selecting 'I Agree', you are providing this transaction an Electronic Signature with the same legal weight as a hand-written signature as defined in the 'Electronic Signatures in Global and National Commerce Act'. You must select ‘I Agree’, or your payment will not be applied.

GOAWAYTRAVEL.COM TRAVEL SPECIALIST

My GoAwayTravel.com Travel Specialist is:

( If you do not know who your Travel Specialist is,
please select “Not Sure” from the drop down list.)

GoAwayTravel.com/Go Away Groups is not responsible for any errors and omissions on this page.