“The Preferred Travel Service Of Peter Hughes Diving”

CREDIT CARD HOLDER’S AUTHORIZATION

Booking Number: _____________ Name(s): ____________________________________

MANDATORY FED EX ADDRESS: _________________________________________

Phone: ________________________Fax/Email:_______________________________________

I authorize Fed Ex to deliver, Yes__ No__ without signature: Yes___ No: ___ Ck and initial:__

In lieu of my signed credit card imprint, I, ___________________________, hereby authorize Peter Hughes Diving, Inc. in behalf of Dive Easy Travel, Inc. to charge my (MC, VI, AX) account number ______________________________________expiration __________ in the amount of US$ ___________________. This represents payment for airline tickets on _______________________ airline to (city) _______________________ departing on (date) __________________ returning on (date) _____________________ for (number) _________ passengers. I am aware of and agree to change/cancellation penalties applicable to the above ticket(s) as follows:

Each change AFTER the ticket is issued: $__________ per ticket before departure date

Cancellation AFTER the ticket is issued: $ __________ per ticket before departure date

REFUNDABLE / NON-REFUNDABLE

I understand that paper tickets will be sent via Fed Ex 3 business days and charged to my credit card unless otherwise authorized. Please initial: _______

I understand that in the event that I or persons traveling on tickets purchased on my credit card cancel, change or do not use any of the purchased services, penalties and/or service charges will apply. By signing below, I acknowledge charges described hereon, and agree not to deny charges in case of any mishap, misunderstanding, or any other extenuating circumstances.

Cardholder’s signature: _________________________________________ Date: ___________

Note: This form must be completed in its entirety and returned asap. Incomplete information or false statements shall be considered sufficient cause for ticket denial. Fares are never guaranteed until ticketed and subject to change without notice. Airline schedule changes are beyond our control and may change without notice.