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To Make Reservations Program: Bay Rock Party Cruise Friday and Saturday: 7 - 9 - 11 pm Please Reserve for: Name:______________________________ Number of Guests: Adults: ___________ Children: ___________ Under 3 Years Free Date: ______________________________ Address:____________________________ City: ____________ State: __ Zip: ______ E-Mail: _____________________________ Phone: ___ - ____ - ______________ Fax: ___ - ____ - ______________ Total Cost: $_______________ Credit Card Payment (No American Express - Sorry) Name of Credit Card Holder: ___________________________________ Number: ____________________________ Expiration Date: __________________ Amount Charged: $ _______________ Please charge the amount in US$$ on the C-Card above. Signature: ___________________________________ Date: _______________________________ For security purposes Fax to: 305-442-9784 Confirmation will be Emailed or Faxed back |