Moon Palace Booking Payment

Number of Rooms*

Room 1*

Name of Main Guest of Room 1*

First Name Last Name

Email*

Cellphone*

Room 2*

Name of Main Guest of Room 2*

First Name Last Name

Room 3*

Name of Main Guest of Room 3*

First Name Last Name

Room 4*

Name of Main Guest of Room 4*

First Name Last Name

Room 5*

Name of Main Guest of Room 5*

First Name Last Name

Price for one room

Price: $1,125.00

Price for two rooms

Price: $1,125.00

Price for three rooms

Price: $1,125.00

Price for four rooms

Price: $1,125.00

Price for five rooms

Price: $1,125.00

Total

$0.00

Total

$0.00

Total

$0.00

Total

$0.00

Total

$0.00

Credit card*

Card Details

Cardholder Name

Cardholder Address*

Street City State Zip Code

Consent*

I agree with the privacy policy and with terms and conditions. I accept that the booking is NON Refundable

Consent*

I agree that I will be charged to my credit card and I will not request a chargeback.

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Payment Moon Palace

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