Tampa Bay Ski Club

Credit Card Authorization Form

PAYMENT METHOD:   VISA  |  MASTERCARD  |  AMERICAN EXPRESS  |  DISCOVER  
CREDIT CARD NUMBER: EXPIRATION DATE:     CVV#: (3-4 Digits)
NAME AS IT APPEARS ON THE CARD:

TRAVELERS NAMES:

TRIP DESTINATION: DATES OF TRAVEL:
AMOUNT TO BE CHARGED TODAY: $

Cardholder has read and agrees to the Cancellation Policy on the Tampa Bay Ski Club Trip Application.
Further, the Cardholder agrees to have the amount above charged on their credit card today.
Additional charges will require a separate authorization.
Cardholder Digital Signature: (Required) Date Signed:
Cardholder Billing Address: City:
State: Zip Code:
Daytime Phone: Email Address: