In lieu of a credit card imprint, I hereby verify I am the cardholder named above and authorize Breedlove Travel (and/or their affiliates) to charge the above credit/debit card for my travel reservation. You are further advised that the posted charge may appear on your statement in the name of Breedlove Travel or one of our affiliates. You may request from Breedlove Travel the name of the affiliate that will appear on your statement. I have read, understand and agree with the AGENCY TERMS AND CONDITIONS and also the supplier terms and conditions provided to me with my invoice. I understand my reservations will not be processed until this completed authorization is received, and if not received within all applicable deadlines my booking may be automatically canceled. I understand and agree with the cancellation penalties associated with this reservation, and have been provided the opportunity to purchase travel insurance. By submitting this payment, I agree to pay the total amount as entered above in accordance with the card issuer agreement. The cardholder understands and agrees to these terms and expressly waives the rights to credit card chargebacks as a means to mediate disputes. *