Credit Card Authorization

Reservation dates:    Arrival date: ___________________          Departure date: ____________________

Amount authorized:   _________-____:                                Currency: _____________    (ZAR, USD, etc.)

Name as it appears on card:  ____________________________________________________________

Card type: _____________________________     (American Express, Diners, Mastercard, Visa, Discover)

Card billing address: ___________________________________________________________________

Issuing Bank or Financial Institution: _______________________________________________________

Expiry Date: __________________                *CCV Code: (if not previously supplied via email) __________

* (Either the last 3 or 4 digit code on the signature block on the back of your card, or the un-embossed numbers on the front, as
in the case of American Express )

I  _______________________, (Full legal name) am authorized to charge to the above credit card. I have
read and understand the Booking Procedures, Terms and Conditions  and Cancellations  policies below, and
have instructed Tsitsikamma on Sea (Pty) Ltd., to charge the amount authorized above.

                                  Authorized signature:  _____________________________

Booking Procedures, Terms and Conditions:  Reservations are accepted via the Internet, telephone, in writing, via mail, fax or e-
mail, and all require a minimum deposit of 50% of the total stay to confirm the reservation. We will only confirm you booking
upon receipt of your deposit. We reserve the right to cancel unconfirmed bookings without deposit, without notice. Deposits may
be made directly into our bank account or by credit card.  Credit card deposits require completing and signing our Credit Card
Authorisation form, and faxing it to us. If you have made an offer from the website, the entire amount offered will be charged to
your credit card, upon our acceptance of your offer.

Cancellations:  We reserve the right to charge: (i)  A fee of 100% of the cost of the total stay if cancelled within 7 days or less
prior to your date of arrival, or in the case of a “no show”; (ii)  A fee of 50% of the cost of the total stay if cancelled less than 14,
but more than 7 days prior to the date of your arrival; (iii) A fee of 25% on the cost of the total stay if cancelled less than 30, but
more than 14 days prior to the date of your arrival. No verbal cancellations will be accepted.  All cancellations are to be in writing.
Ensure you have written confirmation of receipt. Accepted offers cannot be cancelled.

Check in:  Guests have to register and establish credit by authorizing cost of full stay at check-in. Incidental charges are to be
settled at the time of your departure.



FAX THIS COMPLETED FORM ALONG WITH A PHOTOCOPY OF THE FRONT AND BACK OF THE CREDIT
CARD.