Payment Form

Personal Information

Your Name *

Your Email *

Cellphone / WhatsApp Number *

Booking Number *
[text* booking#]

Tour and Date *

On-Island Dates

Island Arrival Check-In Date *

Island Departure Check-Out Date *

Hotel Staying at

Credit Card Information

Type of Credit Card *
—Please choose an option—VisaMaster Card

Card Holder's Name *

Credit Card Number *

Security Code *

Expiry Date:
Month *
—Please choose an option—JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Year *

Total $BZD *

Total $USD *

Billing Address

Street Address *

Street Address Line 2

City/Town *

State/Province *

Postal Code *

Country *

Note: Your card will be charged upon receiving this authorization, the charge will appear as from Ambergris Divers on your account*
I hereby acknowledge and declare that I am the Card Holder of this Credit Card and that I authorize Ambergris Divers to charge my credit card account as indicated within for travel/activity/tour arrangements and services offered and/or contracted via Ambergris Divers. By this means, I fully acknowledge the Terms and Conditions that are applicable to my reservation. I understand that I am responsible for any documentation/certification needed for the activities contracted. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.*

Yes, I Agree

Digital Signature *

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