Security Golf

Rancho Del Sol Golf Club

Credit Card Authorization Form

Please fill out the following information and sign below.

Print name:

Phone number:

Email address:

Credit Card type (check one) Mastercard Visa American Express Discover

Credit Card Number: - - -

Security Code:

Expiration Date: /

Card Holder's Name (print):

(Exactly as it appears on credit card)

Billing Address:

City: State: Zip:

Card Holder's phone number: - -

I authorize Rancho Del Sol Golf Club to initiate a one-time charge to the Credit Card

indicated above for the tournament or group outing.

Amount Authorized: $ .

Card Holder's Signiture: Date:

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