Club at The Del Club at The Del | Page 19

Club at The Del ME M B E R S H I P C R E D I T C A R D AU T H OR I Z AT I O N FOR M Name: ________________________________________________Membership Number: _______________________________ Billing Address: ___________________________________________________________________________________________ City: __________________________________________State:_____________________Zip Code:________________________ AUTOMATIC WITHDRAWAL PAYMENT OPTION — PLEASE CHECK BOX TO PARTICIPATE Yes, I authorize Hotel del Coronado to automatically debit the credit card noted below all monthly charges incurred on my Club account. These charges will include quarterly dues, billed January, April, July and October; all resort charges and F&B minimums. PLEASE NOTE: Automatic debits will be charged prior to the mailing of your billing statement. Confirmation of payment will be reflected on the current month’s statement; bringing the account current reflecting a $0.00 balance. I certify that the below listed card is issued to me and agree that all disputes on my credit card account relating to Club at The Del will be promptly brought to the Club’s attention. This form authorizes only the credit card noted below to be kept on file and to be automatically charged if requested payment option above: American Express Visa MasterCard Discover Credit Card Number: _____________________________________Expiration Date: ____________________________________ Printed Name on Card: __________________________________Co-Applicant Cell____________________________________ Signature: ______________________________________________Date: ______________________________________________ POLICY ON DELINQUENT ACCOUNTS: If your Club account balance is not paid within 30 days of the original billing date, the total account balance will be charged off against a major credit card. At that time, a 1.6% handling fee will also be assessed to your Club account. If your balance is not paid within 30 days of the original billing date, a notice will appear on your statement reminding you that if a payment is not received before the next billing cycle, the account balance will be charged back to your credit card. Therefore, in order to secure that measure, we will require a major credit card number and your signature. Due to credit card regulations, a photocopy of the cardholder’s card imprint (front and back) must be provided upon completion of this form.