I, , am a client of KTA, Inc. d/b/a Brazos Country Travel.  I hereby appoint the owner, manager, and employees of Brazos Country Travel to be my attorneys-in-fact for the purpose of signing any documents necessary to purchase and issue airline tickets and/or other travel documents for the following passenger(s):, and to charge $ to my credit card #, expiration date . 

I authorize any of my attorneys-in-fact to sign for credit card charges on my behalf, and I intend such signature to bind me the same as if I had personally signed for the purchase.  I agree that I will pay for all such purchases and will not hold Brazos Country Travel responsible for any of its actions pursuant to this limited power of attorney. 

Cardholder Name:   Phone:  

Billing Address:  

City/St/Zip:   E-Mail:

NOTE:  Please be aware that after you have made your initial trip deposit, any change or cancellation will result in penalties and/or fees assessed by both the travel supplier and Brazos Country Travel.  
WE STRONGLY RECOMMEND THE PURCHASE OF TRIP CANCELLATION INSURANCE.
I do do not want to purchase Trip Cancellation Insurance.  
So that we can find the lowest priced insurance, please indicate year of birth: 

Signature: Date:  

Type your name in the Signature box, thus indicating your acceptance of all terms and conditions in this Limited Power of Attorney as if you had signed the document.