Rescue Information
Authorized Person on the Account and/or Card
First Name
Last Name
Rescue Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
I authorize Urban Mutt Retreat to perpetually charge to the following described credit card the amount equal to the value of the product/services. I have agreed to allow Urban Mutt Retreat to bill our card individually for each client staying with Urban Mutt Retreat and will mail a copy of the individual invoice to the emails on file. The amounts shall be charged, whenever appropriate and as agreed.
*
Agree
I AGREE to make sure the credit card information is current and provide new expiration date whenever the current card expires
Agree
Submit
Should be Empty: