CREDIT CARD AUTHORIZATION FORM
(for printing and faxing)

Date _____  _____  _____
         Day    Month  Year   

I, _________________________________, hereby authorize to charge my
       name as it appears on the credit
card

Visa / Master Card / American Express (circle one)

Card # ___________________ good thru: ___ / ___ in the amount of $ _____________

I accept the conditions of the reservation and I agree to pay the amount here authorized, even though I have not signed the original charge note or voucher. I agree to pay this amount in case of "no show" or cancellation of any hotel, car rental or tour reservation with less than 15 days notice from date of service. Cancellation is to be done in writing. I am also attaching a copy of my credit card (front & back) for your records. I agree this letter is my personal guarantee for payment.

Signature: ____________________________

Name: Phone: e-mail:
Services:

Please return this form to us via fax to (USA) (305) 716 9216,
or to 011 (506) 520-0468 (Costa Rica)

Thank you for your reservation!