CREDIT CARD FORM
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CREDIT CARD FORM
PAYMENT TYPE: □ 50% DEPOSIT □ FINAL PAYMENT □ OTHER
CHARTERER’S NAME:______________________________BOOKING # : __________________
BOAT NAME:_____________________________________START DATE: __________________
We accept VISA and MasterCard. For your protection, this authorization applies to this payment only. Subsequent credit card payments should be made on separate copies of this form.
I/we authorize Tortola Marine Management Limited to charge my (our) credit card(s) as shown below.
I/we understand that cancellations are subject to the following charges:
• For cancellation 90 days or more before charter start: $300.00 cancellation fee
• For cancellation between 46 to 89 days prior to charter start: 50% of the charter fee is non-refundable
• For cancellation 45 days or less prior to charter start 100% of the charter fee is non-refundable
• All cancellation fees are non-refundable and will not be held as credit towards future charters
VISA □ M/C □ VISA □ M/C □
Card #______________________________________ Card #______________________________________
Security Code #_______________________________ Security Code # ______________________________
Expiration Date_______________________________ Expiration Date_______________________________
Amount $____________________________________ Amount $___________________________________
Cardholder’s Signature: Cardholder’s Signature:
____________________________________________ ___________________________________________
Today’s Date_________________________________ Today’s Date________________________________
Please print name as it appears on card: Please print name as it appears on card:
____________________________________________ ___________________________________________
Card Billing Address: Card Billing Address:
____________________________________________ ___________________________________________
______________________________Zip:___________ _____________________________Zip:___________
Daytime Phone #______________________________ Daytime Phone #_____________________________
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Please FAX this form to Karen @ 1-262-248-1619
or scan/email to karen@
THANK YOU FOR YOUR PAYMENT
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