Credit Card Authorization Form

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3731 Wilshire Blvd. Suite 635, Los Angeles, CA 90010
TEL: 213.368.0303 EMAIL: TRAVEL@POWERHOUSELIVE.NET
Credit Card Authorization Form
I,
, authorize Powerhouse to charge my credit card for the amount
shown below. I also acknowledge that Taeyang Travel Inc., the official travel agency for the tour, shall
charge the international airfare as a part of the package.
Date:
Customer Name:
Charge Amount: $ 500.00 (USD)
$2,499.00 (USD)
Other Amount
Card Holder Name:
Cellphone:
Card Holder Billing Address:
Street 1:
Street 2:
City:
State:
Credit Card Type:
Zip:
VISA
Country:
Master
American Express
Credit Card Number:
Expiration Date:
Card Holder Signature:
CV Code:
$
3731 Wilshire Blvd. Suite 635, Los Angeles, CA 90010
TEL: 213.368.0303 EMAIL: TRAVEL@POWERHOUSELIVE.NET
Cancellation Policy
Please check-mark after carefully reading below policy instructions.
Deposit ($500) is non-refundable.
Penalty may apply if you change the passenger name after the air flight reservation is complete.
You shall receive a full refund except for the deposit, if you cancel the reservation two weeks
prior to the departure date.
You shall receive a refund of 50% of the package price if you cancel the reservation 72 hours
prior to the respective departure date.
There will be no refund, no transfer of name within 72 hours prior to respective departure dates.
If the tour is cancelled by an act of God or by any occurrences outside the reasonable control of
tour operators, we shall refund the full amount including non-refundable deposit.
If customer is gravely ill and advised by a doctor not to travel, we shall refund the full amount
including non-refundable deposit. Customer must present a written document to prove his or
her health condition in the event.
I,
above on this
, have read and agree with the terms and conditions stated
day of
, 2016.
Signature:_____________________________________
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