We accept the following form of payment: (1) Check, Certified check or Money Order.   (2)Credit Cards: American Express, Master Card, Visa or Discover Card Mail Cash or Check Payments and Make checks out to: EthniCity Enterprises Inc 1000 SW 86th Ave Pembroke Pines, Fl  33025 Method of Payment      qCheck      qVisa     qMasterCard   qAmerican Express    qDiscover Authorization to Charge Credit Card   NOTE: Payment for a vacation shall constitute acceptance to all terms & conditions outlined on this web site and form. I, (Credit Card Holder)______________________________________________, authorize charges  to the following credit card  # ________________________________________________________________________________exp. date___________________________ CID CODE # __________________________ 3 digit code on the back of Mastercard and Visa Cards. Appears on the Signature Strip. 4 digit code on the front of American Express Cards. Appears above and to the right of the account number. ________________________________________________________________         ___________________           (card holder signature)                                                                                                         (date) Authorized amount for deposit $__________ to be charged on _______________ (deposit due date) NOTE: If accepting Insurance please include in deposit amount. Authorized amount for final $____________ to be charged on_________________ (Final payment will be charged 45 days prior to travel.) Booking #_______________________________________ Correct Legal Names for all Passengers:__________________________________________________________________                                                                                                                                                                                           Address___________________________________________________________________________________________ City _________________________________________State _________________________ Zip_____________________ Day Time Phone__________________________________ Home Phone________________________________________ Fax___________________________________________ E-mail______________________________________________ Travel Dates____________________________________ Total Trip Cost_______________________________________ Resort_________________________________________ Room Category______________________________________ Is Airfare included in your package?_________________ Air Departure City____________________________________ --------------------------------------------------------------------------------------------------------------------------------------------------------- Delivery of Documents     Your documents will be shipped by one of the following methods:           q US Postal Service (no charge)     q Overnight Fed-Ex($15)       q 3 Day Fed-Ex($8) *recommended* q  Require signature for delivery               q  No signature required for delivery, ok to leave tickets at door step. Ship Tickets To: _________________________________________________________________________________ City ____________________________State _________________ Zip___________________ Phone _________________ --------------------------------------------------------------------------------------------------------------------------------------------------------- Terms & Conditions ~ Cancellation Insurance Waiver I have read, understand and accept the terms and conditions listed below and/or the escapetoeden.com web site.  I am choosing to Accept or Decline the cancellation insurance or pre travel penalty waiver. (include name and signature for each traveler and initial to accept or decline the cancellation insurance/ penalty waiver offered.) Name                                                               Signature                                  Date                  Accept          Decline ______________________________          ______________________         ______          ______          ______ ______________________________          _______________________       ______          ______          ______

Terms and Conditions Cancellations: To minimize penalties, please advise us immediately should you wish to cancel a confirmed reservation.  Cancellation charges are as follows unless booked under a “PROMOTIONAL” fare. (see Additional Charges below for details) 46 days or more/$25.00pp 45-22 days/ $200 pp 21-00 days/ $300 pp Additional Charges: Depending on the tariff, from $75.00 to the full amount of a “PROMOTIONAL” fare may be forfeited. Promotional fares require deposit amounts in excess of the usual $100 deposit per person. Hotel penalties often apply, and the amount varies by hotel. Cancellation penalties may vary depending on travel dates and hotel, due to certain hotel cancellation policies and airfare tariffs. Penalties up to the full amount paid may apply over holidays, peak periods and promotional sales. Cancellation insurance is highly recommended. Revisions/ Changes: Once payment has been received, a revision fee of $15 will be due per booking each time changes are made to a reservation to cover administrative costs. If a revision requires re-issuance of an airline ticket a minimum of $75 per ticket and $20 per hotel voucher will be due in addition to the revision fee. A fee of $100 is due for a lost ticket. Certain airfares due not allow changes of any nature. Late Payments: A late fee of $25 per booking will be assessed to all final payments received after due date. Please complete all sections & fax form to (786) 221-5512