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Insurance Waiver

Please Read This Carefully

Now that you have arranged your trip, as professional travel agents we feel that it is our responsibility to recommend travel insurance to protect your investment. Please read the attached TravelSafe brochure carefully in order to make an informed decision concerning this  important matter. Ask us or call us with any questions you may have.


At the Time of First Payment:

I have been advised of the cancellation penalties for my purchase. I acknowledge receipt of the TravelSafe brochure. 

I understand that TravelSafe Insurance can protect me from possible loss of money due to supplier bankruptcy/default, unexpected trip cancellation/interruption due to accident, sickness or death, baggage loss, medical expenses, and emergency air transportation costs. 

I understand that I must purchase TravelSafe Insurance immediately to obtain maximum coverage. 

Credit Authorization

Form Instructions

It is highly recommended to use a CREDIT CARD AUTHORIZATION FORM for your records for each client’s credit card transaction. This form gives you signed authorization to charge your client’s credit card and protects you in the event of chargebacks, debit memos, and/or disputes. This form is for your own record keeping to be included in your client’s file. It is not necessary to send this form to KHM Travel corporate office or accounting.

It is important to have your client enter his or her name exactly how it appears on their credit card. Example: your client profile information may indicate John Smith; however, the name on the credit card may be Jonathan A. Smith. It is also recommended to keep records of all posted credit card transactions (deposits, additional amounts paid, final payment, etc.) that pertain to each itinerary or trip transaction. Request a copy of the front and back of the credit card and photo ID to retain for your records.

I, 

Client Request

Additional Passenger Names w/ DOB & Relationship (Full Names)

Additional nights before/after our Cruise/Tour?

Quote Information

I authorize charges for the deposit and/or final payment on the credit card listed above (Full Name in Print)

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Call our friendly team at (727) 953-3591.