Wedding Receptions at The Seawatch Restaurant Credit Card Form ~ 2008

Credit Card Authorization All invoices are due in accordance with service order contract terms. After 30 days, if payment is not received, the credit card will be charged. Please print, fill out and fax or mail this form to The Seawatch Restaurant (info at bottom of this page). If you have any questions, contact The Seawatch by telephone at 808-875-8080 or by sending e-mail to info@seawatchrestaurant.com Guest / group name: ______________________________________     Date of event: _____________ (mm/dd/yy) Home phone number: _____________________        Local Maui phone number: ________________ Contract number: ____________________ (located on the top right corner of your service order) I irrevocably authorize my credit card to be used for services at The Seawatch Restaurant, Maui, Hawaii Comments:_________________________________________________________________

Credit card type: ______________________________ (MC, Visa or AMEX only) Credit card number: ______________________________________________ 3-digit (MC/VISA) or 4-digit (AMEX) credit card security number: ________ Located on front of card on AMEX or back of card in signature box on MC/VISA Expiration date: ___________________________ Cardholder: ____________________________________________________ Print name exactly as it appears on card Company name: ________________________________________________ Amount of charge approved: _________________ Billing address: _________________________________________________ City, state, zip: _________________________________________________ Signature: __________________________________________________ I warrant and represent that I am authorized to agree that charges for this event are posted to this credit card.

[Revised 4-17-07] The Seawatch Restaurant 100 Wailea Golf Club Dr Wailea, HI 96753 Tel.   808-875-8080 FAX   808-875-7462 e-mail   info@seawatchrestaurant.com Return to weddings main page.