This form will NOT send your credit card information over the Internet. It will simply allow you to print out a neat, typed authorization form , sign it and fax it to us. Please contact us at travel@costarica.net if you experience any difficulty.

We accept Visa, Master Card, and American Express only.
Please note that we charge a 5% processing fee on all credit card transactions.

CREDIT CARD FORM, FOR THE EXCLUSIVE USE OF
Costa Rica's Travel WEB

THIS AUTHORIZATION COVERS THE SERVICES OUTLINED BELOW:

Date

Description

Amount

Subtotal:
5% processing fee:
Total:

Cancellation and no-show policy: No refund will be issued for no-shows and cancellations made less than seven days prior to reservation date. A 50% refund based on Services Purchased will be issued for cancellations made seven to 14 days prior to reservation date. A full refund based on Services Purchased minus a $35 Administration fee, will be issued for cancellations made more than 15 days rior to reservation date.

I hereby authorize the recipient of this form to charge my credit card for confirmed reservations as outlined above.

Card Holder Name:
Card Number:
Expiration Date:
Telephone:		Fax:
E-Mail IMPORTANT!
Agent's Name
Billing Address:
Authorized Signature:	X Don't forget the signature!