Credit Card Authorization for Self-Guided Vacations 8/07 
FAX to 712 258 1776 or mail to CycleItalia PO BOX 1386 Sioux City, IA 51103

I authorize CycleItalia, LLC to charge the account listed below for the vacation(s) or merchandise indicated. 

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Tour name (or merchandise description)

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Signature of card holder Date

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Name as printed on credit card

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Address

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City State Zip Country

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Billing address (if different from above):

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Phone email

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Number on credit card expiration date

Circle: VISA MASTERCARD

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Amount (US dollars)

I further authorize CycleItalia LLC to charge the balance due portion of my vacation either April 1 (April- July departures) or August 1 (September-October) YES NO

Cancellation Policy: If you must cancel your trip for any reason after final payment has been received a full refund (less the original deposit amount of $500 per person) will be made only if CycleItalia is notified in writing no later than 30 days before the start of your trip. There is NO refund of any kind if you cancel your trip less than 30 days before the scheduled start. We may be able to reschedule your vacation to another date during the same season upon written request, depending on availability. A $250 per person change fee will apply. Trip insurance is available and highly recommended. An application will be included in your initial confirmation packet. 

I have read and understand the cancellation policy above_____________________Initial