Credit Card Authorization Form for Reservation

Beach Riding Vacation Package

This form will NOT send your credit card information over the Internet. 

In order to guarantee your reservation request, please print, fill out, sign and fax this form to our reservation office, fax number 011 (from US & Canada. Other country, call your operator to get the code for Costa Rica) +(506) 2645-7894 or send the form by email as attachment including your signature.

This is required to confirm your reservation for your cabin/room with us. We will confirm by E-MAIL.
CREDIT CARD FORM

 
Date in

Date out

 -Name

   Room

 Persons Amount

 

 Subtotal:
  5%  fee:
  Total:
RESERVATION and CANCELLATION POLICIES: our commitment: Rooms will not be charged, if you cancel them right in time.

All bookings require a 70 hours cancellation notice or the room will be charged as full booking rate
I hereby authorize the recipient of this form to charge my credit card for confirmed reservations as outlined above.
Card Holder Name:  
Card Number:  
Card Type: Visa     Master     AMEX      ____________  
Expiration Date:  
Phone:  
E-Mail: IMPORTANT!
Fax:
to be contacted in Costa Rica:  
Billing Address:  
Authorized Signature:
X
please don't forget SIGNATURE !!!		  

Fax in Costa Rica: +506-2645-7894

or email as attachment

Please contact us if you experience any difficulties with the form or by phone 

Tel: 506-2645-6894 or 506-8385-2424.