Fax Request for Confirmed Reservations
Villas Kalimba, Samara Beach, Guanacaste, Costa Rica

1. Complete ALL fields on the form below. - 2. Print this page - 3. Sign at the bottom of the printed page
4. Fax the page to +506 2 656-0930

This Authorization Covers The Services Outlined Below:

Description 

Amount Total 

Card Type  

Card Number  

Expiration Date  

Card Holder Name  

Billing Address  

Telephone  

Fax  E-Mail 

Cancellation and no-show refund policy:
  • A Full refund for cancellation made more than 31 days prior to reservation date.
  • A 50% refund fro cancellation made 30 to 15 days prior to reservation date.
  • No refund for cancellation made 14 days prior to reservation date.

I hereby authorize the recipient of this form to charge my credit card for confirmed reservations as outlined above.

Authorized Signature:

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