CHUBASCO CHARTERS

P. O. Box N-4344
Nassau, Bahamas
Tel. 242-324-3474  -  Fax 242-364-1612
e-mail - chubasco@coralwave.com

Credit Card Authorization Form


Name (as appears on Credit Card):  ____________________________________________________


Billing address of Credit Card:  _________________________________________________________


______________________________________________________Tel:_____________________________


E-Mail address: _______________________________________________________________________


Credit Card Type: (circle) MasterCard - Visa - Discover - American Express



Credit Card Number: ____________________________________________________Exp. _________



Total amount of payment authorized: __________________________________________________



Authorized for: (service and date) _____________________________________________________



I the undersigned Customer acknowledge that I have read and understand Chubasco Charters cancellation policy and authorize them to bill my credit card for the above amount in the event I do not cancel in the required time frame.



Date:__________________ Signature: ________________________________________


To confirm your charter, please print and fill out this form and fax it to us. Fax: (242) 364-1612.  Please book charter via telephone, e-mail or fax before sending us this form. Please contact us if you do not receive confirmation within 24 hours of faxing us this form.