Print / Credit Card Authorization Form

  1. Credit Card Holder must be traveling. No third party Credit Cards.

  2. Fill out and print completed form, and sign below.

  3. Attach a clear copy of the Credit Card and Photo ID.

  4. Fax to (619) 295-0004 or mail to Mexico Destinations · 1902 Market Street · San Diego CA 92102

All travel documents from credit card payments will be Express Mailed to the credit card billing address.

There will be no exceptions. No documents/service will be released until all roommates are paid in full.

Reservation Tracking Number:    
Arrival Date:        Nights #
Credit Card Holder Name:     
The address entered must match the address where your credit card bill is sent.

Credit Card Holder Billing Address:   

  
City / State:        State
 Zip Code:          Telephone # 

Credit Card Type (Circle One)

 Master Card   ·   Visa   ·   American Express   ·   Discover
Credit Card Number:  
Expiration Date on the Credit Card:  

Passenger(s) Being Paid For Below:

 Amount being charged for each passenger Below:
1 $
2 $
3 $
4 $

Add Processing Fee  

 + $ 25.00

Total Amount to be Charged

 $
I, the undersigned, do hereby authorize Mexico Destinations, INC. dba Mexico Spring Break  to charge the above card in the amount indicated above. I am signing below, acknowledging that I am the cardholder under penalty of law. The cardholder wavers all rights to charge back on the indicated credit card “ I understand that  Mexico Destinations, INC. dba Mexico Spring Break  is not responsible for any personal injury, property loss or damage, inconvenience, time delay, supplier actions (error, omissions, or negligence), strike, hotel overbooking, mechanical problems, bad weather, acts of God, or any other event or circumstance beyond its control.  This credit card authorization does not limit or modify the Reservation Agreement including the trip Information and Conditions, the Disclosure of Limited Liability.  Payments are non-refundable.“         CST # 204254140

Signature of Cardholder                                                                     Date                                

Toll Free ( 888) 295-9669   /   Tel ( 619) 295-5116   /   Fax Number ( 619 ) 295-0004