Disney Booking Form - Wishing Well Travel

Agent *

Lead guest on reservation *

Names of everyone in your traveling party. Please include ages & birthdates of all children. *

Email *

Phone Number *

Address (please include city, state, and zip code) *

Payment Information

If you would prefer to call your Travel Agent with this information please note "called agent" in place of name as it appears on card. If you are using a Disney gift card you can submit that information below. Please include the card number & pin.

Name as it appears on card

Credit Card

Credit Card Number

Expiration Date

CVV Code

Gift Card & Pin #

Is your billing address the same as your mailing address - if no, please enter billing address below.

Billing Address

Payment Options *

Deposit (Future payments will be processed at clients request)

Payment

Full Amount

Amount of Payment *

My Disney Experience

Please enter your My Disney Experience information if you have already set up an account. If you do not have an account set up yet, please contact your travel agent with that information when you do.

Login

Password

Would you like to include Memory Maker for $185?

Yes

No

May add later

Flight Information for Ground Transportation (airline, flight #, arrival & departure times)

Dietary Needs (please list any allergies or dietary restrictions of anyone in your traveling party)

Special Celebrations

Room Requests (connecting rooms or room location, crib, accessible room, any allergies that may need to be noted, etc.)

Additional Information/Miscellaneous

Wishing Well Travel highly recommends vacation insurance be added to all Walt Disney World, Disneyland, Disney Cruise Line, Adventures by Disney, and Disney Aulani vacations to help ensure any problems that could arise from vacation cancellation, interruption and delays that could result in loss of time or money. If you would like to include with deposit, please choose just "accept". If you'd like to add with final payment, please choose "accept" & "add at final payment" options. *

I accept Vacation Insurance

I decline Vacation Insurance

Add at Final Payment

Terms & Conditions

Affiliation and Responsibility 

Wishing Well Travel is an independent travel company. Wishing Well Travel issues travel documents in the sole capacity as agent for the supplier as indicated in travel documents, brochures, quotes or other communication. As the agent of the supplier, Wishing Well Travel  does not assume the responsibility for the cancellation or substitution of service by the supplier, financial default of the supplier, refunds or unused services to be provided by the supplier, or any obligation, service or monies not the specific responsibility of Wishing Well Travel . 

Authorization  

The person submitting this form, being at least eighteen years of age and a legal resident of the United States or Canada, is hereby authorizing Wishing Well Travel to purchase travel and/or other associated travel components with the Credit Card provided. 

Wishing Well Travel must make deposits, progress payments and final payments using its client's credit card(s). Authorization for such payments is granted upon client's submission of his/her payment information to Wishing Well Travel via this web-based submission form. Wishing Well Travel will retain credit card information for future payments in a secure location until time of travel is complete.  Wishing Well Travel  will not apply payments for the client without the client's express permission, granted herein. Wishing Well Travel shall not be held responsible for cancellation of travel by the supplier if resulting from late final payment. 

Accuracy of Information  

The person submitting this form hereby attests, under penalty of law, that he/she is the rightful owner of the Credit Card or Gift Card being used.  Furthermore, the person submitting this form also attests that the billing name and address provided are correctly associated with the payment method used. 

Vacation Protection Insurance  

By submitting this payment, and therefore accepting the Vacation Quote and these Terms and Conditions, the client agrees that he/she was provided the option to purchase Vacation Proection Insurance (except residents of the state of Washington), and made the decision, on their own, to Accept or Decline such insurance. 

Destination Terms and Conditions  

By submitting this payment, and therefore accepting the Vacation Quote and these Terms and Conditions, the client also acknowledges and agrees to the specific Terms and Conditions established by the respective vacation destination, including cancellation policies.  If at anytime the client wishes to no longer work with Wishing Well Travel, the reservation will be cancelled at the clients expense for any cancellation fees based on the destinations terms, conditions and policies. Wishing Well Travel reserves the right to cancel any reservation if we deem it in the company's best interest.


Acceptance  

By checking the box below, and by clicking the "Submit" button, you are authorizing Wishing Well Travel to reserve the specified vacation on your behalf, using the method of payment provided above. Furthermore, you agree that you have read and understand all of Wishing Well Travel's Terms and Conditions, and that you understand the cancellation policies and penalties that apply to your vacation.

Agree to Terms *

I agree to the Terms & Conditions above

Electronic Signature *