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Credit Card Authorization Form (11/2006)
Event Date: ______________
I, _______________________, hereby authorize Last Call Enterprises to charge
my credit card account in the
amount of $_____________ for a security deposit on or
after the date of ___/___/20__. Additionally, I authorize
Last Call Enterprises to charge my credit card account in the
amount of $___________ for payment of services
provided by Last Call Enterprises. I
authorize this payment to occur on or after the date of ___/___/20___.
Cardholders signature X____________________________ Date ________________
Card Type (circle one) VISA MC
AMEX DISCOVER
Card # _______________________________________ ccv # _______ Expiration Date __/__
The ccv # is the 4 digit code on the front of an Amex card
or the 3 digit code on the back of a Visa, MC, or Discover
Name (as it appears on card) ________________________
Credit Card Billing Address
Street __________________________________________
City _______________________ State _____________
Zip Code __________ Telephone ( )______________
E Mail _________________________________________
The fine print –
please read and initial -
Due to the highly customized nature of our tours/events, prices and
availability are subject to change up to 24 hours after booking. 15%
deposit is required at the time of booking. The tour is refundable, minus
the deposit if cancelled 5 full business days prior to the event/tour.
Payment in full must be received 5 full business days before the event
date. If full payment is not received on time the event will be considered
cancelled and the deposit forfeited. If tour/event is cancelled less than
5 business days prior, your entire payment will be forfeited. Show/Event
tickets are not considered part of the tour. Show/Event tickets must be
paid for in full at the time of booking and are not refundable.
Initials _______ |
Fax this form to: 702-920-8525.
Please include a copy (front and back) of your I.D. and the credit card.
Your tour will not be booked until we receive this authorization AND the copy of
the card and I.D.
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