Credit Card Authorization Form


To purchase a Quarry gift card or promotional item please fill out the credit card authorization form below, print it and fax it to us at 210-824-3068.  We will get back to you as soon as we receive it.

This credit card information is secured as payment for specific services or product that will be provided by the Quarry Golf Club.  Your signature gives the Quarry Golf Club authority to charge the total final billing amount for services to your American Express/Visa/Mastercard/Discover credit card.  Please complete the following information along with a copy of the front and the back of the indicated credit card.

I, _________________________________ (name as it appears on card), authorize the Quarry Golf Club to charge my card:

_____ American Express

_____ Visa

_____ Mastercard

_____ Discover

Card #: ________________________________  Exp. Date: __________ for services or products as agreed upon by both parties.

Gift Card Amount: __________                         Mailed to: _____________________

To: ______________________                                         _____________________

From: ____________________                                         _____________________

 

——————————————————-                  Date: __________________
Authorized Signatory For: