Please fill out the following information, PRINT and FAX (or U.S.Mail)
FAX: (888)772-3230 (Start your FAX immediately)
Name on Credit Card
E-mail
Phone Number
Address
City
State
Country
Zip Code
Credit Card Type
Credit Card Number
CCV Nbr (last 3 digits on rear of card)
Expiration Date
Credit Card Deduction
$ CHARGE
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Number Adults:
Number Children:
Number Couples:
Dates From:
Dates To:
Smoking: Yes:
No:
Pets: Yes:
No:
Comments: Approximate Check In/Out Times
Signature of Credit Card Holder
Complete this form on the computer or by hand including CVV number
(CVV number is the last 3 digits on back of VISA card used for security purposes)
Sign the form(s) (also sign the Deposit/Rules Form)
FAX to: (888)772-3230
(or U.S. Mail to: P.O.BOX 55484, St Petersburg, FL 33732)
A receipt will be emailed back to you.