Your Name *
First
Name Last Name:
Your
contact phone number
(country code)
(phone number)
Your
primary Email address *
(Extremely important to receive payment receipt/confirmation):
You must enter a valid email address, or your form won't
reach us properly. So please be sure to type very
carefully! Please also avoid using a Yahoo or an
AOL mailbox here because they can be filtered as spam
and may fail to reach us or you.
Which city and country are you coming from?
(city),
(country)
What is
the nationality on your passport?
Tour Starting Date
01
02
03
04
05
06
07
08
09
10
11
12
Month
01
02
03
04
05
06
07
08
09
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11
12
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31
Day
2021
2022
2023
2024
2025
Credit Card/Debit Card Payment
VISA
MasterCard
American
Express
Discover
Diners
Club
JCB
Do you want to use
the same credit card to
pay your remaining balance later?
Yes
No
Please inform your bank about this coming charge to avoid the payment
declination due to the secure check.
Please be careful to enter valid and accurate
information below, or your payment cannot be processed
promptly.
Card Issuing Bank, e.g. Citibank
Card Number
15-16 digits
(No
space between digits).
Expiry Date (mm/20XX)
(e.g.
12/2026)
CVV Number
(the 3 digits on the back of your card, or 4 digits on American Express)
Name on the card
Cardholder's Address
City
State/Province
Country
Postal
code/Zip code:
Payment Amount
(Please add credit card fee.)
USD
Card Fee : Please add 3.3% surcharge for Visa,
MasterCard, Discover or debit card payment.
Please add 3.8%
surcharge if you use
American Express . For example, if your
payment is $100, then please enter $103.30 for
Visa/MasterCard/Discover, or $103.80 for AMEX.
For no-fee payment, please consider using Zelle, check
or cash.
Promo Code
(If you have multiple promo codes,
please separate them with ",")
Purpose of this payment.
Please enter a brief description
of the tour you have
booked.
AUTHORIZATION
By submitting this form, I authorize Great Wall
Adventure Club to charge my Credit Card/Debit Card indicated above for
all obligations contracted from the hiking and China travel service
ordered. I hereby agree to accept sole liability for the payment of all
charges of Great Wall Adventure Club services regardless of whether
access permission was granted by myself. The payment given here is
non-refundable, unless otherwise stated in our cancellation policy.
"Great Wall Adventure Club" is to appear on my statement.
ELECTRONIC SIGNATURE
Please type your full name in the spaces below to
electronically sign. Then click "Submit! I Agree to Pay!"
button to submit your payment.
Please re-type to verify.
Today's Date: