CREDIT CARD AUTHORISATION FORM

(Red ink displays most prominent on faxes)



I, .................................................................... (please print)

authorise Knysna Terrace to charge my credit card

Type of card: [Master Card / Visa / American Express / Diners Club]

Number: ............................................................................

Expiry date: ........../...........      Last 3 digits on reverse of card: .................

ID/Passport number: ..............................  Nationality: .............................

Arrival date: ........./.........../200.....   Arrival time: ...........am / pm

Departure date: ........./.........../200.....   Departure time: ..........am / pm

Room type: [ Deluxe Room / Superior Room / Standard Room ]     Number of rooms: ....

Number of adults: .....     Number of children: .....      Child ages: ................

Please list all the other names in your party here:
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................

Telephone: ................................. (B)     .................................. (H)

.................................C/M)  Email: .................................

for the amount of R ........................ (South African Rand) for my reservation, (50% deposit required to secure booking - Full payment required 4 weeks before arrival)

Signed: .................................................. (Credit Card Holder)

Date: ........./............./2005




Please return the completed form to one of the contacts below

Fax: 0866 400 037 - South Africa (+27 11 507 5045)

Email: info@knysnaterrace.co.za

Cancellation fees
14 days 1 day or no show
50% 100%