Fax Request for Confirmed Hotel Reservations
Samara Beach, Guanacaste, Costa Rica

1. Complete ALL fields on the form below.
2. Print this page.
3. Sign at the bottom of the printed page.
4. Fax the page to the Hotel where you are requesting Guaranteed Reservations.

This Authorization Covers The Services Outlined Below:

To: 

Description 

Amount Total  

Card Type  

Card Number  

Expires  

Card Holder Name  

Billing Address  

Telephone  

Fax  

E-Mail  


Cancellation and no-show refund policy:
  • No refund for no-shows and cancellations made less than 7 days prior to reservation date.
  • A 50% refund for cancellations made 7 to 14 days prior to reservation date.
  • A Full refund for cancellations made more than 15 days prior to reservation date.

I hereby authorize the recipient of this form to charge my credit card for confirmed reservations as outlined above.

Authorized Signature:

X