Days Inn High Prairie Box 820 4125-52 Avenue High Prairie, Alberta, TOG1EO Phone: (780) 523-3050 Fax: (780) 523-3181 a ¢, reservations@daysinnhp.ca Credit Card Authorization Form hereby authorize Days Inn High Prairie to charges to be applied to the following credit card. on cone_L~ ONE TIME ONLY visat 4520 8850/9859 0/68 exe OF , 23 MIC # EXP I AMEX # EXP L Please check off all that apply. Room, Tax & Incidentals. iY Laundry Services, (ANCONO) seers Charge Meals Name of Card Holder: Mirer/le To upiv Signature of Card Holder me Ach a Please Photocopy front and back of credit card along with 2 pieces of photo ID and fax or email to number/email provided. Guest Name(s): (i/,///a LAG Company Name: Kap Caz. Date of Arrival: _/7/. bY, eo Date of Departure: /Zzrop s'/-2_/ y net ‘At check out fax (ai nai receipt to: PIU CAH Ohapid sez +" cive receipt to quest. Please fax or email to the Days Inn High Prairie prior to quest arrival,