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Encanta La Vida Reservation Form
The credit card authorization below must be printed out and faxed to us at 011-506-2735-5678.
Name: _____________________ Arrival: _____________________ E-mail: _____________________ Departure: _________________ Fax: _______________________ Phone: ____________________ Alt Phone: _________________
Rates and Methods of Payment
$ 85 per person per
day (+ 16.39% tax) = $98.93/person Pole House
$ 95 per person per
day (+ 16.39% tax) = $110.57/person Ranchito Room
Children under 8 years pay 50.00 (+ 16.39% tax) = $58.20
Adults _____ x _____ (rate) x _____ (nights) = _______ Total Lodging Children _____ x _____ (rate) x _____ (nights) = _______ Total Lodging
Total Lodging ________ x 50% = ________ Deposit Required
Balance of 50% on total is due upon arrival.
I authorize Encanta La Vida Rainforest Lodge to charge the following amount to my Credit card and additional amounts pursuant to the Cancellation policy below (with or without my signing the voucher).
Card Number: __________________________ Exp Date: _________________
Name (as appears on card): __________________________________________
Signature: ___________________ Passport #:_____________________________
50% deposit being made by: VISA ( ) Master card ( ) Check to U.S. office* ( ) Please make the check out to Brian Daily 1187 Coast Village Rd Ste 302 Monticito CA 93108
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© 2000 Encanta La Vida, S.A. • All Rights Reserved
Lodge Inquiries:
info@encantalavida.com
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