Share your information with Karla Bronaugh

Karla Bronaugh

Carefully Planned Travel, LLC

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	<fields><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="paragraph" subtype="p" label="I authorize CPT to charge my credit card on my behalf through their applicable payment processors. I certify that I am an authorized user of this credit card and shall not dispute these approved transactions with my bank or credit card company for any and all charges related to my travel and event arrangements as confirmed with CPT. I certify that the information listed on this credit card authorization form is true, complete and accurate. "/>&#13;
		<field type="paragraph" subtype="p" label="By my electronic signature of this form, I authorize charges to my credit card through applicable payment processors of CPT or their suppliers. Other charges for travel accommodations will vary based on your plans and the suppliers utilized to secure your travel plans. "/>&#13;
		<field type="paragraph" subtype="p" label="•	Chargebacks resulting because you do not agree with the cancellation policy."/>&#13;
		<field type="paragraph" subtype="p" label="•	Chargebacks resulting from force majeure or other circumstances that are beyond the control of CPT or the supplier."/>&#13;
		<field type="paragraph" subtype="p" label="•	Chargebacks arising from inconsistency or inaccuracy with regard to the supplier’s product description."/>&#13;
		<field type="paragraph" subtype="p" label="•	Chargebacks resulting from charges authorized by family, friends, associates or other third parties with direct access to your credit card. This does not include credit card fraud."/>&#13;
		<field type="paragraph" subtype="p" label="•	Chargebacks resulting from non-cancellable reservations, whether or not the reservation is used."/>&#13;
		<field type="paragraph" subtype="p" label="Chargebacks: In certain cases, you can dispute charges with credit card companies (&quot;chargebacks&quot;). You agree not to make any improper chargebacks. Before initiating a chargeback, we ask you first to call us to discuss any questions or concerns about our charges. We will work with you in attempting to resolve your concerns. By using our service to make a reservation, you accept and agree to our cancellation policy. CPT retains the right to dispute any chargeback that is improper and recover any costs, including attorney’s fees related to improper chargebacks. Additionally, in the event of an improper chargeback, we retain the right to cancel any travel reservation related to that improper chargeback. The following chargeback scenarios are improper, and we retain the right to investigate and rebut any such chargeback claims:"/>&#13;
		<field type="paragraph" subtype="p" label="Cancellations and Refunds: I, the undersigned, understand the cancellation and refund policy of CPT, found in the Terms and Conditions, the chargeback policy described below, as well as the cancellation and refund policies of any suppliers (collectively, the “Travel Terms and Conditions”). I, the undersigned, understand and agree that travel arrangements may be subject to NON-REFUNDABLE cancellation penalties as outlined in the Terms and Conditions.  By authorizing a payment, I also agree to the full Terms and Conditions, and I acknowledge and understand the cancellation and refund policy for my travel itinerary. "/>&#13;
		<field type="paragraph" subtype="p" label="For your protection and ours, we require a signed credit card transaction authorization form to process the payment for services. Please carefully read and understand the below prior to executing this Credit Card Authorization Form."/>&#13;
		<field type="paragraph" subtype="p" label="Thank you for choosing Carefully Planned Travel, LLC (“CPT”) to assist with your travel and planning needs."/>&#13;
		<field type="header" subtype="h2" label="Full name on card"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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 type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="select" label="Select" name="select" className="form-control">&#13;
			<option label="Cruise deposit" value="cruise-deposit" selected="selected">Cruise deposit</option>&#13;
			<option label="Cruise full payment" value="cruise-full-payment">Cruise full payment</option>&#13;
			<option label="Accommodations (all inclusive, resort, hotel)" value="accommodations-all-inclusive-resort-hotel">Accommodations (all inclusive, resort, hotel)</option>&#13;
			<option label="Transportation (shuttle, car service, airline)" value="transportation-shuttle-car-service-airline">Transportation (shuttle, car service, airline)</option>&#13;
			<option label="mobility rentals or mobility rental protection " value="mobility-rentals-or-mobility-rental-protection-">mobility rentals or mobility rental protection </option>&#13;
			<option label="Travel Protection" value="travel-protection">Travel Protection</option>&#13;
			<option label="Bar Tab" value="bar-tab">Bar Tab</option>&#13;
			<option label="Excursions" value="excursions">Excursions</option>&#13;
		</field>&#13;
		<field type="text" label="Enter the amount to authorize:" name="amount" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date Field" name="date-1745947856229" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Header"/>&#13;
		<field type="header" subtype="h2" label="Billing&amp;nbsp; Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
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Enter the amount you would like to authorize:

Please add or choose card to authorize:

Sign and agree to the terms and conditions:

By signing below, I authorize Carefully Planned Travel, LLC to charge the credit card provided herein.

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