Credit Card Authorization Form printable pdf download

Credit Card Authorization Form

CREDIT CARD AUTHORIZATION FORM

This form must be filled out completely in order for us to process your request.

Please check one.

Visa _____

MasterCard _____

Discover _____

Account #___________ ____________ ____________ _____________

Expiration date: ______________

Name as it appears on the card: ___________________________________________

The Last 3 Digits of the code found on your card’s signature strip:___________________

I Authorize Aqua Cat Cruises to charge the amount of: _______________________

Signature: _____________________________________________

Billing Address: _________________________________________________

_________________________________________________

Trip Date:

______________________________

Cancellation Policy:

Individual:

1) More than 90 days prior to departure, a full refund less $250.00

2) 90-61 days prior to departure, and the deposit is forfeited.

3) Less than 60 days, no refund.

If the trip departs full, we will refund ALL deposits and payments.

3700 Hacienda Blvd, Suite G, Fort Lauderdale, FL 33314

Toll Free: (888) 327-9600

954.734.7115 • Fax: 954.321.6582

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Email:

Credit Card Authorization Form