Name: _____________________________________________ Email: _______________________
Billing Address: ______________________________________ Phone: _______________________
___________________________________________________ Fax: _______________________
Check in Date: ___________________ Name on Room or Group Name: _____________________________________

I have read and understand the cancellation policy. I further agree that I am assuming all risks and Resort Adventure Centers, Inc, Frenchman’s Reef & Morning Star Marriott Resorts, its employees and agents, assume no responsibility or liability for death, personal injury, property damage, loss or consequential loss of any kind whatsoever which may be incurred during the course of, or arising from my use of the premises, equipment or services provided. Furthermore, I shall be liable for any and all damages or loss to the equipment specified herein. ______________________________________________ (Signature Required)

_________________________________________ __________________
CREDIT CARD NUMBER EXP. DATE
If using American Express, please provide the 4-digit printed code above the account number: ___ ___ ___ ___
If using Discover, VISA or MasterCard, please provide the 3-digit printed code on the signature panel: ___ ___ ___
______________________________________ __________________________________________
Cardholder (please print name as it appears on card) Cardholder Signature

Payment information must accompany this form.
PLEASE FAX YOUR COMPLETED FORM TO (340) 774-3732


APPROVAL CODE: ______________
PROCESSED BY - AGENT: ______________________
(OFFICE USE ONLY)