Share your information with Amber Robinson

Amber Robinson

Make It Last Travel

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		<field type="header" subtype="h2" label="Payment Authorization Form"/>&#13;
		<field type="paragraph" subtype="p" label="Please be advised it may take 1-2 business days to process. If urgent processing is needed due to other pending pending charges. Please don’t hesitate to reach out.&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="Travel Advisor - Amber Robinson"/>&#13;
		<field type="paragraph" subtype="p" label="www.makeitlasttravel.com"/>&#13;
		<field type="paragraph" subtype="p" label="404-956-9497"/>&#13;
		<field type="paragraph" subtype="p" label="Payment Authorization &amp;amp; Client Agreement"/>&#13;
		<field type="paragraph" subtype="p" label="By submitting this form, I authorize Make It Last Travel Agency to charge my provided payment method for agreed-upon travel services, including deposits, final payments, service or planning fees, and approved add-ons."/>&#13;
		<field type="paragraph" subtype="p" label="I understand that travel planning and booking services are rendered at the time of booking. Payments processed are considered earned and are non-refundable, subject to supplier terms and conditions, regardless of whether I later cancel, change plans, or choose not to travel."/>&#13;
		<field type="paragraph" subtype="p" label="I acknowledge that Make It Last Travel Agency acts solely as an intermediary between myself and third-party suppliers. All refunds, credits, penalties, and travel disruptions are governed by supplier policies, many of which are non-refundable and outside the agency’s control."/>&#13;
		<field type="paragraph" subtype="p" label="I agree not to dispute or charge back any authorized transaction. Initiating a chargeback or payment dispute constitutes a breach of this agreement and may result in cancellation of services and refusal of future bookings."/>&#13;
		<field type="paragraph" subtype="p" label="By submitting this form, I confirm that all information provided is accurate and that this submission serves as my authorization and consent, binding under applicable law."/>&#13;
		<field type="textarea" label="Comments or Specific Payment Arrangements" name="comments-or-specific-payment-arrangements" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Booking Number" name="text-1781564916627" subtype="text" className="form-control"/>&#13;
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Enter the amount you would like to authorize:

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Please add or choose card to authorize:

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Please add or choose card to authorize:

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Sign and agree to the terms and conditions:

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Sign and agree to the terms and conditions:

By signing below, I authorize Make It Last Travel to charge the credit card provided herein.

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