Credit Card Authorization Form

Full Name *Name as it appears on the Credit Card

Credit/Debit Card Number *Please enter your Card Number0 / 19

Credit Card Expiration Date *

MM

YY

Cardholder ZIP *Enter the zip code of the address where the credit card bill is sent

CVV *This is the 3 digit code on the back of your credit card

Email *

Consent

Yes, by checking this box I {name-1} authorize VegasNightsOut (can appear as Expedia or Insider on a customer's bank statement) to charge the credit card indicated in this authorization form. The payment authorization is valid for one (1) use only. I certify that I am authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in the invoice/quote that I have already received for this booking.

Date: 11/14/2024 Your IP: 162.144.20.146