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VIP PARTY PACKAGE # 2 |
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I, , hereby authorize Club Deep Inc. to charge my credit card account in the amount of $ 50% Deposit PRINT YOUR NAME AS IT APPEARS ON CARD |
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VISA |
MasterCard |
American Express Discover |
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Credit Card Number: Expiration Date: / VID Code: |
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Credit Card
Billing Address: Street: City:
State:
Country: (if not US) Telephone: () Cell # ()
Email:
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VIP Birthday Special # of Guests Party Date |
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I Understand that this charge is non refundable.
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FAX FORM TO CLUB DEEP 305-532-1593 |
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