Credit Card Authorization

The Ridge at Castle Pines

                                                                                                                    1414 Castle Pines Pkwy.

Castle Rock, CO  80108

                                                             (303) 688-4301 phone

                                                                                                                              (303) 688-0128 fax 

Card Holder Information: (Please Print)

Name:                                                                                              Phone:  _____________________

Address: ___________________________________________

Card Type: Visa/ Master Card/ American Express           

Card Number: _______________________________________             Expiration:_____________________                   

ITEMS TO BE PURCHASED:

( )         Ladies Event Payment:            Dollar Value Please Circle One:      $35 Passholders  $55 Non Passholders

TO:____________________________________________________

FROM:_________________________________________________

FOR:___________________________________________________

VALUE:_________________________________________________

( )         Green Fees:                 # of Rnds.:                    Fees w/Tax: $_____________               

I authorize The Ridge at Castle Pines North to charge above credit card for the total amount due:

Name on Card (please print)______________________________  Amount $:____________________

Signature: ____________________________________________  Date:________________________

Photo Copy of Front of Credit Card                              Photo Copy of Back of Credit Card

Photo Copy of Front of Drivers License