Dabble in Travel Client Information Form

Primary Contact Information:

Full Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Country Code Area Code Phone Number

E-mail *

Additional E-mail (optional)

Emergency Contact Name (someone not traveling with you) *

First Name Last Name

Emergency Contact Phone *

Country Code Area Code Phone Number

Room Reservation Details:

Check In Date *

Month Day Year

Check Out Date *

Month Day Year

Desired Room Type *

Bed Preference (if applicable)

Please reference the bed options for your selected room type on the website (e.g. For the 4 bedroom villa, enter "2 kings, 1 queen and 2 twin-sized beds" or "2 kings and 4 twin-sized beds"). Bed preferences are noted but not guaranteed.

If you are sharing a multi-room villa with another party and paying for your deposits separately, please add their names here:

Do you require any special assistance? Please note the Windjammer Landings resort is NOT handicap accessible, however we can accommodate you in a room with a straight walk in. *

Yes No

Flights & Airport Transfers

Would you like to book your airport transfer in advance (recommended)? *

Yes, I would like to reserve spots on a group transfer, if possible Yes, I would like to reserve a private transfer No thanks, I will find my own way to the resort

Would you like assistance booking flights or more details about the group flights? *

Yes, please send me more details about a possible group flight (Chicago or Detroit) Yes, I would like assistance booking a flight from another city No thanks, I'll book my own flight

Passenger Names: (Please List Full Legal Names of All Passengers)

Full names must be listed as they appear on your government issued identification and passport for all travelers. If additional space is needed use the space located at the bottom of the form.

Please include the information of the person completing the form, if that person is traveling.

Passenger 1 *

Prefix First Name Middle Name Last Name

Birth Date *

Month Day Year

Passenger 2

Prefix First Name Middle Name Last Name

Birth Date

Month Day Year

Passenger 3

Prefix First Name Middle Name Last Name

Birth Date

Month Day Year

Passenger 4

Prefix First Name Middle Name Last Name

Birth Date

Month Day Year

All names and dates of birth listed above are as they appear on the respective government issued identification for each named person *

I agree

Travel Insurance:

I have been advised of the option to purchase travel insurance. *

I agree and understand that my investment is at risk if insurance is not purchased.

If you choose "Accept" below, I will send you additional details about the insurance and work with you to purchase the appropriate amount of coverage.

Please note that insurance is bought on an individual basis, so if for example you are sharing a multi-room villa, not all people in the villa need to purchase insurance.

Passenger 1 Insurance Coverage *

Accept Decline

Passenger 2 Insurance Coverage (if applicable)

Accept Decline

Passenger 3 Insurance Coverage (if applicable)

Accept Decline

Passenger 4 Insurance Coverage (if applicable)

Accept Decline

Passports/Visas:

I have been advised of passport/visa requirements related to my trip and understand it is my responsibility to ensure I meet the entry requirements *

I agree

Cancellation Policy:

I have been advised that there will be no refunds available after October 27, 2017 (unless you accept the insurance above) *

I understand

Questions/Comments:

Please use this area to include any special needs or additional info you wish to share.

Credit Card Information:

To remain PCI complaint, I cannot collect your credit card details on this form. In order to complete your booking, please text or call +1 312-883-4787 or email the below details to susie@dabbleintravel.com. If you email, please separate your details into at least 2 emails for security purposes.

Billing Address (only if different than the address you included in the form)
Name as listed on your card
Credit Card Type
Credit Card Number
Credit Card Expiration Date
Credit Card CVV (3 or 4 digit code)

Desired Payment Plan *

*Monthly Payments will incur an additional one-time $25 processing fee

Amount Approved to Charge Now *

The minimum deposit is $150 per person

Card Holder Authorization

I, the above-named authorized credit card user, give Susan Chau of Dabble in Travel and Classic Vacations (hotel payment processor) authorization to charge my credit card for the purposes detailed above. I understand that this form constitutes a legally binding contract and that by affixing my signature to this form, I will be held responsible for all agreed upon (as stated above) charges.

By signing this "Credit Card Authorization" form, I acknowledge receipt and understanding of its contents, I agree to the accuracy of the information disclosed within this form, and to the authorization to charge my credit card for the amount specified above.

Signature *

Clear

Enter the message as it's shown for security purposes *

Note: Your card will not automatically be charged by completing and submitting this form; however, completing and submitting this form does give the agent the right to charge the card for the amount and purpose authorized above.

Client Information Form

Card Holder Authorization

By signing this "Credit Card Authorization" form, I acknowledge receipt and understanding of its contents, I agree to the accuracy of the information disclosed within this form, and to the authorization to charge my credit card for the amount specified above.

Thank you for your business!