Credit Card Authorization Form

I hereby authorize Sugar Tree Cafe to charge my credit card for my private event on (date)

Type of Card *

Visa
MasterCard
Discover
Amex

Name of Cardholder *

Credit Card Number *

Expiration Date *

CVV *

Credit Card Billing Address *

Address Line 1

City

State

Zip Code

Phone Number

Email *

Authorization Signature of Cardholder

Clear Signature

By signing this, I acknowledge the charges described on this form, assume full responsibility for said charges, and agree to honor and abide by the terms of payment. I acknowledge and accept Sugar Tree Cafe's Terms and Conditions.

Event Details

Occasion/Event Name

Number of Guests

Date / Time of Event

Time

Signature

Clear Signature

Date

Credit Card Authorization Form

Event Details

Nutley, NJ

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