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Registration form - Sea Cloud Cruises

Registration form - Sea Cloud Cruises

Registration form - Sea Cloud Cruises

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Name:<br />

Address:<br />

Credit Card Authorization Form<br />

(Please print clearly)<br />

I hereby authorize SEA CLOUD CRUISES GmbH as agent for the owners to make charges in the amount of:<br />

US$ to my credit card.<br />

(10 % Deposit immediately)<br />

US$ to my credit card.<br />

(90 % Balance on)<br />

Ship Departure Date<br />

City: State: Zip:<br />

Name as it appears on the credit card (if different than above):<br />

Select type of card:<br />

❑ Visa ❑ Master Card ❑ American Express<br />

Card Number: 3 or 4-digit code:<br />

Expiration date:<br />

Cardholder Signature Date:<br />

SEA CLOUD CRUISES GmbH, An der Alster 9, 20099 Hamburg<br />

Telefon: +49-40-30 95 92-50, Fax: +49-40-30 95 92-22, E-Mail: Info@seacloud.com

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