Payment Authorization

The Gates on Roblin requires a credit card to be kept on file for all group bookings and orders. The Client understands that deposits and final payments are due upon receipt. If the client fails to remit full payment for the hired services within the given timeframe, The Gates on Roblin reserves the right to process the outstanding amount on the credit card provided below. A late payment fee of 2% will be assessed on all overdue accounts.

I hereby authorize The Gates on Roblin to charge my credit card for any and all deposits and/or final payments concerning the hired services by The Gates on Roblin for my function. I understand that I will be able to review and approve any charges prior to processing unless I fail to make payment within the given terms.

EVENT DETAILS

Function Name:

Function Date

Year

Month

Day

Function Time

Time

Function Space

Approx. # of Guests

Client Contact

Company name (if applicable)

Contact Name

Email Address:

Phone Number:

Mailing Address

Payment Authorization

Credit Card Type

Mastercard

Visa

American Express

Name on Card

Expiration Date:

Card Number

Security Number

Form submission date:

Year

Month

Day