Credit Card Authorization form for Destination Wedding

This form is for you to authorize payment for a room on an additional or different card, or to authorize an additional payment on the card you used when you made your room reservation. Only complete this form is you have already completed a room reservation form.

Person completing this form - must be the person whose card is being used. *

Best way to reach you if we have a question about this form. *

Please tell us what wedding you will be attending (bride and/or groom's names) *

Names of the guests in this room. *

Amount you are authorizing to charge to the card. PLEASE NOTE - THE CARD WILL NOT AUTOMATICALLY BE CHARGED WHEN YOU SUBMIT THIS FORM. YOU WILL BE SENDING THE INFO TO AVENTINA TO BE CHARGED MANUALLY. *

Date that we can charge the card. * +

Leave this space blank

Are you authorizing any future payments? *

Yes - I will indicate amount below

No

Future payment amount you are authorizing. *

Date when this amount can be charged. * +

Name on Card *

Billing Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Country *

Email Address *

Phone number *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

Security Code *

I am authorizing a payment on this card in the amount indicated above. I promise to pay such amount to Aventina or any tour operator, vendor, supplier, cruise line, etc. that Aventina uses to book my trip. I also agree to the terms in the room's original reservation agreement whether that agreement included approval to charge on this card, or a different card. Agreed by card holder by signing below: *

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Please use this space to provide any additional information you would like us to know.