Payment Authorization Form

First name of Cardholder

Last name of Cardholder

Phone

Booking Number

New Card? Please note that payments with new credit cards cannot be processed using this form. Contact us directly to provide new card information and authorization.

Payment Amount

Schedule Payment Date

Card Type

VISA

MasterCard

AMEX

Discover

Last 4 Digits of Card Number

By providing your credit card information, you authorize LEAP Travel to charge your card for the agreed-upon amount related to your travel booking and services. This authorization applies to deposits, final payments, and any other charges directly related to your travel itinerary.

You acknowledge that all payments are subject to the terms and conditions of the travel suppliers involved, and you agree to abide by those terms, including any applicable cancellation or change fees. LEAP Travel will not be held liable for any changes, cancellations, or fees imposed by third-party suppliers.

By submitting your credit card information, you agree to these terms and authorize the charges as outlined.

Payments made to LEAP Travel cannot be canceled or refunded once scheduled, and you accept responsibility for all charges made as part of your booking.

Payment Authorization Form

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