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BMD Travel and Tours Vacation Package Payment Form |
| NOTICE: For ALL Check or Credit Card Payments: BMD Travel and Tours gladly offers automatic debiting. To initiate, simply complete an "Automatic Debit Request" form with your credit card or check information, including the desired debit amount, and select the frequency of the automatic debits. We will reply with a confirmation email to confirm your request. In addition, you will receive an email to confirm every subsequent debit, after processing has been completed. | |
| Group Name/Lead Client: | |
| Reservation/Booking #: | |
| or | |
| Destination: | |
| Departure Date: | |
| BMD Reservation Agent: | |
| Name Age Date of Birth | |
| Passenger #1: |
|
| Passenger #2: | |
| Passenger #3: | |
| Passenger #4: |
|
Include Trip Cancellation Protection Insurance Yes No
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| Lead Client/Passenger #1 Address: | |
|
Select Address Type: |
|
| Contact Phone | (include area code): |
| Contact Email Address: | |
| Document Shipping Address, (if different from above): |
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NOTE: Please, only one payment form per room, even if multiple rooms are reserved with the same booking number.
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Method of Payment:
To process your credit card using BMD Travel and Tours, LLC's secured credit card processing, simply complete the registration form and select the "Complete Your Payment" button below. You will then be directed to our secured Check or Credit Card payment forms to process your payments.
| *Amount: | $ |
I authorize BMD Travel and Tours to charge my credit card for the amount
indicated above (Required for Processing your registration): Yes No
To process your check payment using BMD Travel and Tours, LLC's secured e-check payment processing, simply complete the registration form and select the "Complete Your Payment" button below. You will then be directed to our secured Check or Credit Card payment forms to process your payments.
| *Amount: | $ |
I authorize BMD Travel and Tours to debit my checking account for the amount
indicated above (Required for Processing your registration): Yes No
I agree to the following...
Agree Disagree
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You
may also, mail or fax all payments and registration forms, by printing this
completed form, along with a copy of your check or credit card and driver's
license or state issued ID (front & back) and mail or fax to:
812 Forest Hollow
Hurst,
TX 76053
Fax: (817) 285-9225
Attn: Accounting
You
may also call or email all credit card payments to:
(817) 282-2597 or Toll-Free (877) 406-8820
Email: payments@bmdtravel.com