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1-800-741-7956 North America . 0808-234-1714 United Kingdom . 1-416-588-5000 Worldwide . 1-647-945-8807 Fax

Credit Card Authorization

Full Name of Guest Traveling (Name as it appears on credit card)*

Is The Above Guest The Credit Card Holder?*

Yes

Address of Card Holder*

Select Tour Booked*

Tour Start Date*

Year

Month

Day

Type of Card*

Visa

Mastercard

American Express

Discover

CAD Visa Debit

USD Visa Debit

Choose Type of Payment*

Enter last 6 digits of credit card used*

In the amount of:*

I, as the guest entered above have authorized ElderTreks/Passages Exotic Expeditions Ltd. to charge the aforementioned amount on the form of payment provided. I understand that ElderTreks will process only such charges on the credit card(s) as the card

issuing company allows. ElderTreks has USD as well as CAD bank accounts and is not responsible for foreign transaction fees charged on your card.

I understand that ElderTreks will process only such charges on the credit card(s) as the card issuing company allows. ElderTreks has USD as well as CAD bank accounts and is not responsible for foreign transaction fees charged on your card.

I further declare that the signature appearing below is identical with the signature appearing on

my credit card (s).

Signature of card Holder*

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