Walt Disney World Resort

Please Note: This form securely sends your personal & credit card information to your Travel Agent. It does not automatically charge your card. Once your agent receives the form, they will process the payment directly with the travel supplier. Payments can take up to 48 hours to be processed.

Travel Agent Name *

How many people are in your immediate travel party? *

Do you already have a MyDisneyExperience Account? * 🛈

Yes

No

My Disney Experience Account Info : What is your log in Username and Password?

Your agent will set up a My Disney Experience account for you and relay the password to you. This password should not be changed until after you travel as your agent needs access to manage booking.

Are you celebrating anything on this trip?

Check-In Date * +

Please provide confirmed travel dates and what hotel you are interested in, what dining plan you would like and what ticket package you have decided on! *

Traveler 1

Full Name Traveler 1 *

Birth Date Traveler 1 * +

Gender Traveler 1 * 🛈

Magic Band Color Traveler 1

MagicBand Name Personalization Traveler 1 🛈

I would like more information about upgraded Magic Band Options (fee applies).

Yes

Food/Other Allergies / Dietary Restrictions

Traveler 2

Full Name Traveler 2 *

Birth Date Traveler 2 * +

Gender Traveler 2 * 🛈

Magic Band Color Traveler 2

MagicBand Name Personalization Traveler 2 🛈

I would like more information about Magic Band Options (fee applies).

Yes

Food/Other Allergies / Dietary Restrictions

Traveler 3

Full Name Traveler 3 *

Birth Date Traveler 3 * +

Gender Traveler 3 * 🛈

Magic Band Color Traveler 3

MagicBand Name Personalization Traveler 3 🛈

I would like more information about upgraded Magic Band Options (fee applies).

Yes

Food/Other Allergies / Dietary Restrictions

Traveler 4

Full Name Traveler 4 *

Birth Date Traveler 4 * +

Gender Traveler 4 * 🛈

Magic Band Color Traveler 4

MagicBand Name Personalization Traveler 4 🛈

**Note that complimentary Magic Bands are only offered for check-in's 12/31/2020 and earlier. If your trip is in 2021 please chat with your agent about Magic band options.

I would like more information about upgraded Magic Band Options (fee applies).

Yes

Food/Other Allergies / Dietary Restrictions

Traveler 5

Full Name Traveler 5 *

Birth Date Traveler 5 * +

Gender Traveler 5 * 🛈

Magic Band Color Traveler 5

MagicBand Name Personalization Traveler 5 🛈

**Note that complimentary Magic Bands are only offered for check-in's 12/31/2020 and earlier. If your trip is in 2021 please chat with your agent about Magic band options.

I would like more information about upgraded Magic Band Options (fee applies).

Yes

Food/Other Allergies / Dietary Restrictions

Traveler 6

Full Name Traveler 6 *

Birth Date Traveler 6 * +

Gender Traveler 6 * 🛈

Magic Band Color Traveler 6

MagicBand Name Personalization Traveler 6 🛈

**Note that complimentary Magic Bands are only offered for check-in's 12/31/2020 and earlier. If your trip is in 2021 please chat with your agent about Magic band options.

I would like more information about upgraded Magic Band Options (fee applies).

Yes

Food/Other Allergies / Dietary Restrictions

Traveler 7

Full Name Traveler 7 *

Birth Date Traveler 7 * +

Gender Traveler 7 * 🛈

Magic Band Color Traveler 7

MagicBand Name Personalization Traveler 7 🛈

**Note that complimentary Magic Bands are only offered for check-in's 12/31/2020 and earlier. If your trip is in 2021 please chat with your agent about Magic band options.

I would like more information about upgraded Magic Band Options (fee applies).

Yes

Food/Other Allergies / Dietary Restrictions

Traveler 8

Full Name Traveler 8 *

Birth Date Traveler 8 * +

Gender Traveler 8 * 🛈

Magic Band Color Traveler 8

MagicBand Name Personalization Traveler 8 🛈

**Note that complimentary Magic Bands are only offered for check-in's 12/31/2020 and earlier. If your trip is in 2021 please chat with your agent about Magic band options.

I would like more information about upgraded Magic Band Options (fee applies).

Yes

Food/Other Allergies / Dietary Restrictions

Authorization to Charge Credit Card

Completing this form authorizes your Magic Plus Travel agent to charge your credit card listed below. Your agent cannot proceed with your booking until this form is received!

Please note that Magic Plus Travel does not charge your credit card. All Charges to your credit card will be made by The Walt Disney Travel Company

Amount to Charge *

Use this card for: *

Deposit

Magic Band Charging

MagicBand Charging Pin (4 Digits) 🛈

Magic Plus Travel strongly recommends that clients purchase travel insurance. I hereby verify that I have reviewed my travel itinerary for accuracy. I have been advised of all fees imposed by suppliers, and I have been offered the option of purchasing travel insurance. I understand that any changes to my reservation may result in additional cost and/or penalties. I have also read any applicable travel advisories pertaining to my destination and hold Magic Plus Travel and my travel agent, harmless for any issues arising in transit to, from, or at my destination. Would you like insurance to be included in your package for $82.50 per adult and $6.00 per child 17 and under? This is non-refundable and can be added until final payment is made. If you choose not to include insurance in your package - by signing below you are acknowledging that we addressed the addition of insurance and you have chosen to forgo adding it to your package. *

Yes - Please add the insurance to my reservation!

No - I understand the above, and wish to travel without trip insurance. I assume all responsibility for any fees or penalties that may arise.

Disney Terms & Conditions- Park Pass Waiver

By checking this box and signing this form I agree to allow my Magic Plus Travel agent to accept Disney's Terms and Conditions for my park pass reservations in regards to COVID-19 and understand that I am bound by Disney's Terms and Conditions as well and do not hold the agent or agency responsible. This is the only way to allow us to maintain our concierge services for you!

Click HERE to read the Terms & Conditions

*

Yes my agent may agree to the Terms and Conditions on my behalf

No I will make my own park reservations on My Disney Experience and agree to the Terms And Conditions on my own.

Billing Information

By checking this box I agree that my credit card information will be kept on file to be used for future payments and applied only at my direction, Authorization for future payments may be expressed in another format such as by phone or email.

Future CC Payments

I have reviewed the reservation dates and times, payment due dates and cancellation policy made on my behalf by Magic Plus Travel, and I agree that they are accurate. I understand that Magic Plus Travel is not responsible for any cancellation, errors or omissions on my behalf or on the behalf of the vendors providing travel services as a result of this reservation.

I also further agree that should I cancel this reservation, any additional reservations including but not limited to dining, enchanting extras, etc. made on my behalf by Magic Plus Travel will also be cancelled.

Magic Plus Travel Cancellation Fee Policy:

Your travel agent works on a commission basis. When travel is cancelled after bookings have been made, your agent does not get paid for their time. As such, by submitting this form and booking your Walt Disney World vacation through Magic Plus Travel, we reserve the right to charge your card a $50 fee for booking cancellations. This fee increases to $100 if cancelling after dining is booked, and $150 after fast passes are booked but before the 30 day mark. Finally, a $200 cancellation fee will be assessed for reservations cancelled within 30 days of travel.

Signature *

clear

Date * +

First Name *

Last Name *

Country *

Full Address *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Name on Card *

Credit Card Type *

Check here if you are paying with Disney Gift Card(s)

Disney Gift Card

Please enter the Disney Gift card 16 digit number from the back as well as the 8 digit security code. Please include the amount of the gift card!

Gift Card Number 🛈

Security Code 🛈

Gift Card $ Amount

If you have additional Gift Cards, please enter them here, including the 16 digit card number, 8 digit security code, and $ amount on the card

Disney Gift Card Users please NOTE: to pay online using this form, you must also submit a valid credit card payment of $1.00 which will NOT be processed, and also add the gift card numbers and amounts below.

Credit Card Number *

CVV * 🛈

Expiration Date (mm/yy) *