Desert Sand Resort

Credit Card Authorization Form

*Please do not submit this form unless you have been instructed to do so by our reservation specialists.

* Required Fields

First Name

Last Name

Address

Address 2

City

State

Zip

Phone

Credit Card Security Code

(3 digits) *

Deposit Amount

Check In Date

Check Out Date

I have read and agreed to the Motel Policies and give the Desert Sand Resort Motel permission to charge my credit card for the deposit amount entered above.	*
I understand that misrepresentation of any information will void my reservation.	*


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