Credit Card Authorization

Thank you for submitting your group registration page or booking from to Pollin Group!

If you have not done so already, please contact your Cruise Specialist if you have any questions about your upcoming cruise.

The following form is secured from Cruise One/Pollin Group and Go Daddy.

If you are a single passenger, please fill out the information provided and move to the next page.

Thank you!

Payment Information

You may use this form to submit your credit card information to apply a payment for your upcoming cruise! **All information on the Pollin Group Website is secured and protected by GoDaddy. If you choose to provide this information by Phone, Personal Checks, Cashier Checks, and Money Orders, please contact your Cruise Specialist for further instruction and information.

First Passenger Information

Name *

First

Middle

Last

Gender *

Birthdate *

Citizenship *

Phone # *

Email *

Confirm Email

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Please check the box below to indicate your preference on LeisureCare Insurance

I opt out of the insurance provided by CruiseOne/Pollin Group
I opt into the insurance provided by CruiseOne/PollinGroup and accept that I will be charged the price in addition to the deposit price

If you do not wish to select the travel insurance for your cruise, please select above. Otherwise, your first invoice will reflect the price to include your travel insurance.

Second Passenger Information

Second Passenger Name

First

Middle

Last

Gender

Birthdate

Citizenship

Phone #

Confirm Email

Address

Address Line 1

Address Line 2

City

State

Zip Code

If you wish to opt out of the insurance, please check the box below.

I opt out of the insurance provided by Pollin Group/CruiseOne

If you do not wish to select the travel insurance for your cruise, please select above. Otherwise, your first invoice will reflect the price to include your travel insurance.

Third Passenger Information

If you are traveling with a 3rd or 4th passenger in your cabin, please fill out the information below. If the email, phone or address is the same as an above passenger, you may leave that information blank.

3rd Passenger Name

First

Middle

Last

Gender

Birthdate

Citizenship

Phone #

Confirm Email

Address

Address Line 1

Address Line 2

City

State

Zip Code

If you wish to opt out of the insurance, please check the box below.

I opt out of the insurance provided by Pollin Group/CruiseOne

If you do not wish to select the travel insurance for your cruise, please select above. Otherwise, your first invoice will reflect the price to include your travel insurance.

Fourth Passenger Information

4th Passenger Name

First

Middle

Last

Gender

Birthdate

Citizenship

Phone #

Confirm Email

Address

Address Line 1

Address Line 2

City

State

Zip Code

If you wish to opt out of the insurance, please check the box below.

I opt out of the insurance provided by Pollin Group/CruiseOne

If you do not wish to select the travel insurance for your cruise, please select above. Otherwise, your first invoice will reflect the price to include your travel insurance.

Cruise Information

Cruise Sailing *

Please select the name of the cruise that you are making a payment for.

Cruise Specialist *

Please select the name of the Pollin Group Cruise Specialist on the account or select "other" if you don't see them listed.

I acknowledge and accept the terms that the Program Fee is non-refundable. *

I Acknowledge and Accept
No Program Fee Required

The only exception would be is if the cruise was cancelled by the Crusie Line and/or Group Leader/Organizer.

Payment Information- First Passenger

Cruise One/Pollin Group accepts all major credit cards.

Name as it appears on the Card *

First

Last

Card Number *

Exp. Date *

Billing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Amount to be submitted: *

Please indicate the amount that you would like to have charged, it must meet the minimum deposit due.

* Name of additional passengers(s):

If you are paying for more than 1 person with the amount submitted above, please add their name(s) separated by a comma.

I authorize CruiseOne/PollinGroup to charge my credit card with the agreed amount above. *

Authorization *

I elect to keep my information on file for payment of each deposit due to be made on the day it is due until my balance is paid in full.
I will contact Pollin Group each time a deposit is due until my balance is paid in full.

Payment Information- Second Passenger

If the second passenger is paying separately, please fill out the information below. Cruise One/Pollin Group accepts all major credit cards.

Name as it appears on the Card

First

Last

Card Number

Exp. Date

Billing Address

Address Line 1

Address Line 2

City

State

Zip Code

Amount to be submitted:

Please indicate the amount that you would like to have charged, it must meet the minimum deposit due.

I authorize CruiseOne/PollinGroup to charge my credit card with the agreed amount above.

Please type your name as consent for Cruise One/Pollin Group to charge your credit card.

Authorization

I elect to keep my information on file for payment of each deposit due to be made on the day it is due until my balance is paid in full.
I will contact Pollin Group each time a deposit is due until my balance is paid in full.

Payment Information-Third Passenger

If the third passenger is paying separately, please fill out the information below. Cruise One/Pollin Group accepts all major credit cards.

Name as it appears on the Card

First

Last

Card Number

Exp. Date

Billing Address

Address Line 1

Address Line 2

City

State

Zip Code

Amount to be submitted:

Please indicate the amount that you would like to have charged, it must meet the minimum deposit due.

I authorize CruiseOne/PollinGroup to charge my credit card with the agreed amount above.

Authorization

I elect to keep my information on file for payment of each deposit due to be made on the day it is due until my balance is paid in full.
I will contact Pollin Group each time a deposit is due until my balance is paid in full.

Payment Information-Fourth Passenger

If the fourth passenger is paying separately, please fill out the information below. Cruise One/Pollin Group accepts all major credit cards.

Name as it appears on the Card

First

Last

Card Number

Exp. Date

Billing Address

Address Line 1

Address Line 2

City

State

Zip Code

Amount to be submitted:

Please indicate the amount that you would like to have charged, it must meet the minimum deposit due.

I authorize CruiseOne/PollinGroup to charge my credit card with the agreed amount above.

Authorization

I elect to keep my information on file for payment of each deposit due to be made on the day it is due until my balance is paid in full.
I will contact Pollin Group each time a deposit is due until my balance is paid in full.