Client Intake Form

Please note by filling out this form, your card will not be charged immediately upon submission.  Vic will make your deposit when she manually books your trip. 

Main Traveler Contact Information

Please enter your full legal name as it appears on your passport.
 +
Gender (as it appears on your passport) *
 
Are you celebrating anything special with this trip (honeymoon, birthday, anniversary, etc)? *
What are you celebrating? *
 
Is anyone in the reservation present or past Law Enforcement, Military or IAFF Union Member?
Please email Vic a copy of your ID so she can process your relevant discount, if applicable.
If you have TSA Precheck or any airline frequent flyer numbers (for the airline you will be flying for this trip), please enter those here.
 Member #Description
TSA Pre Check
Airline Member #
Airline Member #
Other
Other

Additional Travelers

Additional Traveler #1
 Additional Traveler #1
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other Info
Additional Traveler #2
 Additional Traveler #2
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other
Additional Traveler #3
 Additional Traveler #3
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other
Additional Traveler #4
 Additional Traveler #4
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other
Additional Traveler #5
 Additional Traveler #5
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other
Additional Traveler #6
 Additional Traveler #6
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other
Additional Traveler #7
 Additional Traveler #7
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other
Additional Traveler #8
 Additional Traveler #8
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other
Additional Traveler #9
 Additional Traveler #9
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other
Additional Traveler #10
 Additional Traveler #10
*First Name
*Middle Name
*Last Name
*Date of Birth (mm-dd-yyyy)
*Gender
TSA Precheck # (if applicable)
Airline Frequent Flyer # (if applicable)
Other
I have confirmed the spelling of names and birth dates for all travelers, including myself, is correct as I entered it above. I understand if I have any incorrect information submitted on this form, I may be subject to change fees from the airline. *

Passport Information

To travel internationally, you must have a passport BOOK that is valid through at least 6 months beyond your travel dates.  A passport card is not a valid passport for entry to another country.
 
Cruises that start and end in the US, as well as domestic travel, do NOT require a passport book, and a passport card can work as a form of identification, but ANY international travel must have a book. 
Passports: *
 

By e-signing below, I understand that I will need a passport book if I am traveling internationally.  (For domestic travelers, please draw an X in the box). *
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Insurance Selection

Select your vacation provider/destination: *
SANDALS TRAVEL INSURANCE
Sandals offers travel insurance I can purchase for you at time of booking.  Read more about Sandals insurance here. 

I absolutely suggest insurance on your trip to cover medical needs as well as possibly missed days of your trip due to flight delays/cancellations. Please note by selecting ACCEPT I will be adding insurance at the time of booking making your initial deposit $346.

Note, this insurance will not cover your flights, so I will send you a link to an insurance company I recommend that you can use to purchase insurance for covering air only.
 *
SANDALS & NON-SANDALS SPLIT STAY TRAVEL INSURANCE
Vic will contact you to discuss your travel insurance options. In general... *
DISNEY ACCOUNT
If you have not already, please create your Disney account now!
Please spell names of guests in full, no nicknames (i.e. make sure you write out Victoria, not Vic, on this form and on your Disney account!)

https://disneyworld.disney.go.com (also download the My Disney Experience app!)

DISNEY TRAVEL INSURANCE
Please select your travel insurance option: *
I acknowledge that by selecting Disney insurance, my initial deposit will be $200 PLUS the insurance amount (i.e. for 2 adults, the insurance is $190, so the deposit due at booking will be $390.) *
TRAVEL INSURANCE FOR EUROPE TRIPS
Please see specific terms and conditions for your Europe FIT trip
I understand that my itinerary was quoted and will be booked with a Credit Insurance policy (unless otherwise noted on my itinerary). *
 
I booked elements of trips on my own (hotels, flights, etc.) and would like additional insurance coverage and for my agent to send me more details. *
EXCELLENCE RESORTS TRAVEL INSURANCE
GENERAL Pricing Estimates are as follows:
For a $3,000 trip, expect your insurance policy to cost around $200.
For a $6-8000 trip, expect your insurance policy to cost around $200.
For an $11,000 trip, expect your insurance policy to cost around $550.
 
Please note that insurance pricing can vary greatly depending on your state of residence, ages and number of travelers, and travel dates.
 
Feel free to use this link to get a feel for how much insurance for your own trip would cost, but note that I will send you your specific quote after booking!
Please select if you would like to purchase travel insurance. If you accept, Vic will send you a travel insurance quote through ARCH after your trip is booked. *
TRAVEL INSURANCE
- Read more about credit vs. cash back insurance
- Watch Vic's Video about travel insurance
 
- TRIP CREDIT travel insurance - If you cancel for any reason you will receive a credit through the supplier you have your trip booked through that can only be used with that supplier. There will not be an option for cash back.
- CASH BACK travel insurance - typically 150% more expensive to purchase than a travel credit policy.
- DECLINING travel insurance - I recommend travel insurance on all trips, especially when leaving the country. Keep in mind that you purchase insurance for the unforeseen circumstances that could arise during your trip, which are typically significantly more expensive than the cost of travel insurance.
Please choose the type of travel insurance you would like to purchase.
Please see your proposal to see what type of insurance I initially included in your trip's quoted cost. 

If we quoted with a credit insurance policy you were given a lower deposit (Typically around $300-$800) IF we move to cash back from a credit quote the low deposit goes away making the deposit around half of the cost of the total trip. Note that cash back insurance is, on average, $150 more per person. *
By signing below, I certify that I have read and understand the travel insurance options presented to me. I am signing on behalf of my entire traveling party. I agree to PURCHASE the type of travel insurance that I selected in my response above. *
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Are you sure you want to decline travel insurance? *
By signing below, I certify that I have read and understand the travel insurance options presented to me. I am signing on behalf of my entire traveling party. I DECLINE the opportunity to purchase travel insurance to protect my trip. *
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Please note that you have declined travel insurance through the supplier of your trip.  There is an opportunity to purchase 3rd party travel insurance at a later time, however, please note that this will not cover any reimbursement for pre-cancellation (i.e. if you cancel your trip prior to going for any non-covered medical reason there will be no reimbursement). However, if you choose to add 3rd party travel insurance later to cover accidentals on your trip, you may do so.

Payment Information

Please submit the credit card that you would like to use to pay for your trip. Should you need to update/change your credit card details at a later time, you may contact Vic directly to make these changes.
Please DO NOT enter a debit card, as most resorts will not accept debit cards.  Please enter a credit card instead if at all possible.
Please be advised by agreeing to book this trip, you are agreeing to allow me to make credit card charges on your behalf. These charges will only be on the credit card you have provided, and will be made at deposit, final payment, and any other payments you direct me to make.
 
 
NOTE: Excellence Resorts do not accept Discover cards!
Visa, AmEx, or Mastercard only.
Visa
By e-signing below, I have read and accept the terms of the Credit Card Authorization Form. *
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E-Signatures

TERMS AND CONDITIONS
By signing below, I certify that I have read and accept the Terms and Conditions and the Client Agreement with Vic's Vacations and Bethany Travel. I am signing on behalf of my entire traveling party. *
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Additional Information

Thank you for filling out this form.  I look forward to booking your trip!!