11th Annual Passport to Discovery
Travel Package
Friday, August 7, 2021 - Wednesday, August 12, 2021
Yes! I’d like to secure the travel package for $249.00 per person.
Flights will be booked on an airline selected by Barbizon Travel Agency (NO REQUESTS
ACCEPTED). Scheduled to fly Saturday 8/7/21 & returning Thursday 8/12/21. Travel package
includes roundtrip airfare and roundtrip ground transportation to the Orlando International Airport.!
Name of Contestant Traveling (Name as appears on Gov’t ID):
First: _______________________ Middle: _______________________ Last: _______________________!
Date of Birth: _____/_____/__________!
Name of Registered Guest(s) Traveling (Name as appears on Gov’t ID):
First: _______________________ Middle: _______________________ Last: _______________________!
Date of Birth: _____/_____/__________
First: _______________________ Middle: _______________________ Last: _______________________!
Date of Birth: _____/_____/__________
First: _______________________ Middle: _______________________ Last: _______________________!
Date of Birth: _____/_____/__________!
Select dates for transaction by entering amount & date. Deadline: February 15, 2021!
October: ______ $_____ November: ______ $_____ December: ______ $_____ January: ______ $_____ February: ______ $_____
Payment Authorization Information
Credit/Debit Card Number: _________________________________ Exp. Date: _________ CVV: _____!
Name as it appears on card: _________________________________ Total Amount: $ _____________!
Cardholder’s Primary Phone: ______________________ Email: _________________________________!
Billing Address: _________________________ City: _____________________ State: _____ Zip: ______
Cardholder Signature: ________________________________________________ Date: ______________!
Travel Refund Policy: All cancellations must be made in writing to Barbizon USA - Passport to Discovery, 4950 West Kennedy
Blvd. Suite 200 Tampa, FL 33609 via certified mail return receipt requested. If cancellation is affected within 14 days after
Acceptance Date, all monies paid will be refunded within 30 days of receipt of written cancellation, otherwise all monies are
non-refundable and non-transferrable. NOT RESPONSIBLE FOR LOST / STOLEN LUGGAGE!
No! I do not want to sign up for the travel package. I understand I will be responsible for my
own transportation.
