GOOGLE PAY TRAVEL FORM

This GOOGLE PAY option is a mobile payment service developed by Google and administered thru PayPal. Maduro Dive has no access to any personal information supplied other than what is required for servicing and payment(s), deposit and/or final payment, associated with the supplied Maduro Dive invoice RV # specified. ALL MADURO DIVE PRICING IS IN UNITED STATES DOLLARS BUT BILLED TO YOU IN YOUR LOCAL CURRENCY . For your security, all information submitted is fully and safely encrypted. Your submission of this form acknowledges your responsibility for all money owed to Maduro Dive for deposit and/or final payment.

*Indicates required information in order to submit.

Reservation Information*

Departure Date*

Return Date*

Destination*

Maduro Invoice RV#*

First Name*

Last Name*

US Dollar Amount*

CHECKING THE BOX TO THE LEFT DENOTES ACCEPTANCE OF OUR Terms and Conditions*

CHECKING THIS BOX AUTHORIZES PAYMENT TO MADURO TRAVEL/MADURO DIVE*

CHECKING THIS BOX ACKNOWLEDGES MADURO DIVE HAS NO ACCESS TO YOUR PERSONAL GOOGLE PAY INFORMATION*

CHECKING THIS BOX ACKNOWLEDGES YOU HAVE BEEN PROVIDED THE LINK FOR TRAVEL TRIP INSURANCE*

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GOOGLE PAY TRAVEL FORM

Reservation Information*

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