STONEY CREEK TRAVEL, 16 Camelfield Rd., Weaverville, NC 28787,

Epic Journeys

Debit or Credit Card

Number

Security Code

Exp. Date (mm/yy)

Person's Name On The Card

Address Where You Get Your Statements

Trip Date:

Trip Description:

I consider this credit card authorization form to be as binding as a credit card imprint and I am using it in lieu of an imprint. I am authorizing the above charges.  I agree to not dispute any charges listed on this form or cause any charge backs to the suppliers named on this form or to Stoney Creek Travel for the trip purchase or any applicable fees for the payment of the trip as noted in Trip Description above..  Stoney Creek Terms & Conditions. 

Sec. Code is 3 Digits On Card Back of MasterCard/Visa/Discover. & 4 on front of Am. Exp.

Type of Card

Traveler Information: 

Auth. Fee Payment

CREDIT CARD AUTHORIZATION FORM --  Submit Via E-mail (Click Submit)

or Fax to 877-271-5348

828-658-2582 / 877-658-2582

TYPE THE NAME OF COMPANY(S) SUPPLYING YOUR TRIP -- SUCH AS Carnival Cruise Line, DFW Tours, Holiday Inn, etc

Travel Guard Ins.

Stoney Creek Travel Procurement Fee: Custom Trips or  Air, Hotel, Car

Signature

Home Page

Terms & Conditions

Trip Registration Form

Cruise Registration Form

Navigation & Disclaimer

Authorized Dep.$$$ Amount (If Any)

Auth. Full or Final Payment  and $$$ Amount (If Paying Deposit, Write N/A)

Authorized Insurance Payment Amount

Comments or Questions

Emergency Contact Name & Phone:

Name On Travel ID:

Mailing Address:

Birth Date:

Gender:

Name On Travel ID:

Birth Date:

Gender:

Name On Travel ID:

Birth Date:

Gender:

Name On Travel ID:

Birth Date:

Name On Travel ID:

Birth Date:

Gender:

Home Phone:

Cell Phone:

Work Phone:

Date:

Gender: