CC Authorization Form - Catherines Cafe

I hereby authorize Sheer Rocks to CHARGE the card indicated in this authorization form according to the terms outlined below

Name *

First

Last

Please enter the name for the booking, if it differs from the lead card holder.*

Name (As Shown On Credit Card): *

First

Middle

Last

Reservation Reference No.

Email *

Credit Card Type: *

Credit Card No.: *

Exp Date: *

Security Code: *

Amount US$: *

Credit Card Image Upload ( Front & Back ) *

Click or drag a file to this area to upload.

Proof of Identification (Name Must Match Credit Card) *

Click or drag a file to this area to upload.