Registration & Payments for SunUrBearBunz!
First Guest, First Name: First Guest, Last Name:
Second Guest, First Name: Second Guest, Last Name:
Street Address: Apt #:
City: State/Province: Zip or Postal Code:
Country: Room Type: Make a Selection Non-Smoking Double / Ocean Front: $300pp Dep./Bal. $825pp. Smoking Double / Ocean Front: $300pp Dep./Bal. $825pp. Non-Smoking Single / Ocean Front: $300 Dep./Bal. $1,295. Smoking Single / Ocean Front: $300 Dep./Bal. $1,295. Non-Smoking Double / Ocean View: $300pp Dep./Bal. $575pp. Smoking Double / Ocean View: $300pp Dep./Bal. $575pp. Non-Smoking Single / Ocean View: $300 Dep./Bal. $950. Smoking Single / Ocean View: $300 Dep./Bal. $950.
Method of Payment: Check/Money Order Credit Card Credit Card Number: Expiration Date (mm/yy):
Credit cards accepted by Country Hills Travel are: The American Express family of cards, The Novus/Discover family of cards, MasterCard and VISA, and Bank ATM/debit cards co-branded with these card logos.
Name as embossed on the card:
If using a Credit Card: I authorize Country Hills Travel to charge the amount of $ to the credit card whose number I have entered above.
Telephone: E-mail address:
(Please include your telephone country and city codes if outside the United States, Canada, or Puerto Rico).
Please note: All fields above are required in order to sign-up or make a payment.
Regarding Trip Cancellation/Interruption Insurance, I Make A Selection Choose to Accept the offered product. Choose to Decline the offered product. desire more information, please contact me. am just making a payment on my balance.
By initialing this box, I certify that I have read and agree to the group Terms & Conditions.
Submit My Registration Clear This Form
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