Tot Town Rental

Credit Card Authorization Form

 

Name of Renter *
Name of Renter
Phone *
Phone
Complete Address *
Complete Address
Authorization
By checking the box, I hereby authorize Tot Town LLC to debit the account associated with the credit card information provided below for all rental fees and additional surcharges as stipulated in the Rental Agreement, which I have reviewed, acknowledge and am in full agreement with. I understand that if any charge is declined, I must remit payment due immediately via cash or certified check