Samana All-Inclusive Pre-Payment

Affiliate Key:

Last Name:

Email:

Confirmation Number:

Arrival Date:

Departure Date:

All-Inclusive rate from Confirmation Documentation for Affiliate:

All-Inclusive rate from Confirmation Documentation for Guests:

Name

Guest/Affiliate

Adult

12+

Child

3-11

Infant

0-2

Check-in Date

Check-out Date

No. of nights

All-inclusive cost

Total

Please fix the following errors in the table:

Total:

Card Holders Full Name

Credit Card Number

Expiry Date

Security Code

Billing Address

City

Zip Code

Only affiliates’ credit cards are accepted.
Payments can be made via Visa or MasterCard only.
The pre-payment will not be refunded.
Pre-payment needs to be received at least 7 days prior to the arrival.
Please double check all the information before sending, Chairman’s Circle Club is not responsible for any errors.