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Air Reservation Signature

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Number of Travelers: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_1327818" ]
Your Class of Service: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_5086489" ]
Your Seat Preference: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_2187839" ]

Primary Traveler Information: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_1812913" ] [esigcaldera formid="CF5942d8b64e94b" field_id="fld_5874646" ] [esigcaldera formid="CF5942d8b64e94b" field_id="fld_7124494" ] [esigcaldera formid="CF5942d8b64e94b" field_id="fld_7740288" ] [esigcaldera formid="CF5942d8b64e94b" field_id="fld_3137967" ] [esigcaldera formid="CF5942d8b64e94b" field_id="fld_7806752" ]

PAYMENT INFORMATION:

Name of Cardholder: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_4979405" ]
Credit Card to Charge: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_6535819" ] CVV: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_5067923" ] Expiration Date: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_3381590" ]
Amount to Charge: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_5423159" ]

BILLING INFORMATION:

[esigcaldera formid="CF5942d8b64e94b" field_id="fld_5852245" ] [esigcaldera formid="CF5942d8b64e94b" field_id="fld_2838924" ], [esigcaldera formid="CF5942d8b64e94b" field_id="fld_2043447" ] [esigcaldera formid="CF5942d8b64e94b" field_id="fld_5923028" ] [esigcaldera formid="CF5942d8b64e94b" field_id="fld_7606585" ]

Please charge my credit card referenced above in the amount of [esigcaldera formid="CF5942d8b64e94b" field_id="fld_5423159" ] . I understand and accept all of the terms and conditions regarding this booking, including cancellation policies and applicable penalties, and agree not to dispute, nor chargeback, any of the above charges. I agree that payments may be made direct to selected travel suppliers on my behalf by Shoreside Travel, paid in prorated amounts not to exceed the sum total of approved charges. I also understand that a ticketing fee will be charged for air only reservations and may appear as a separate transaction on my credit card statement.

I acknowledge that I have been offered Travel Insurance to protect my vacation.

If you are using a debit card with a daily spending limit, it is your responsibility to contact your bank to give them permission to authorize the transaction. If they require the name of the vendor and you are unsure as to who that is, please contact us so we may assist you.

Confirmations will be sent to this email address: [esigcaldera formid="CF5942d8b64e94b" field_id="fld_9800295" ]

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Timestamp

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June 15, 2017 1:45 pm CDT

Air Reservation Signature Uploaded by David Glenn - davidglenn@shoresidetravel.com IP 104.190.245.211