INSTRUCTIONS:  PLEASE COMPLETE THE FORM BELOW AND FAX TO AIM HIGHER TRAVEL AT 206-339-2469

SuperClubs

CREDIT CARDHOLDERS AUTHORIZATION FORM

I, _______________________________________________ , hereby authorize International
         (Print name of cardholder as shown on credit card)
 Lifestyles, Inc. (Worldwide representative of SuperClubs) to charge my credit card:

CC# _____________________________________   Exp. Date ________________________

In the amount of US$ ___________________   for reservation # ______________________

NOTE:

  • Credit Card identification is required. Photocopy the credit card (both sides) and driver's license or passport of the cardholder and send attached to this form. (Copies must be legible)

  • For a full refund, cancellation of reservations must be received by SuperClubs twenty-two (22) days prior to the scheduled arrival date. Cancellations twenty-one (21) days or less prior to arrival, or no shows, will be charged $250 per adult. (Greater penalties apply to holiday periods. Check your invoice.)

  • Airline Tickets once issued are not refundable.

My billing / mailing address is:

Street Address: ____________________________________________________________

City: ________________________________   State: _____________   Zip: _____________

Country: ___________________

Cardholder’s Signature: ___________________________________   Date: _____________

Aim Higher Travel