Reservation Pre-Authorication Form

    Attention to:* (required field)

    (Please make sure that you put attention to the correct name to avoid being charged twice)

    Fill up your Party Information Below:

    Discussed Total quoted party price to be payed in CASH USD $* (required field)

    Date of party* (required field)

    Preferred Time* (required field)

    One Hour window of arrival just in case unforeseen issues arise: to

    Party Address & ZIPCODE too

    First Name

    Last Name

    Primary contact cell phone

    Back up cell phone

    What Costume (e.g School-Girl,Maid,Cop,Fire,Hotel Manager,Pizza Delivery,50 Shades Darker,Cowboy,Dr,Delivery,Suit), Superhero/Villain-Batman,Black Panther,Captain America,Deadpool,Harley Quinn,Hulk,Joker,Iron Man,Spider Man,Super girl,Superman,Thor,Wonder Woman,)Other or just dress sexy ? :

    Priority list of 3-5 dancers you like from the site, for alternates in the case issues arise ?

    What type of event (Bachelor/Bachelorette , Birthday, Night Out, Divorce, Solo, Prank):

    How many Dancers?

    CANCELLATION FEE PER PERFORMER

    Full name as appears on credit or debit card* (required field) :

    Credit card number* (required field):

    Expiration date* (required field):

    Month:

    Year:

    Security number on back or front of card* (required field) :

    Full credit card billing address* (required field) :

    DEPOSIT for the PHONE CALL RESERVATION ONLY as a service, not the dancers deposit (NON-REFUNDABLE) * (required field) (Put NUMBERS only e.g. 25,100,1000)

    Zipcode* (required field) :

    Phone* (required field):

    Email* (required field)

    Sign and date print full name*: (required field)

    Proof of Partial Payment (this is your card) (NON-REFUNDABLE) : (Please use Mouse or Touchpad for signature below)

    Being the cardholder or Corporate Officer, by signing this proof of purchase, I understand and agree to the terms set forth in this agreement, agree to pay, and specifically authorize to charge my credit card, for the products or services provided. I further agree that in the event my credit card becomes invalid, I will provide a new valid credit card upon request, to be charged for the payment of any outstanding balances owed. I furthermore confirm that I have received all services and goods to satisfactory conditions.

    I Agree to the Terms and ConditionsI Agree to the Terms and Conditions

    I Agree to the Refund PolicyI Agree to the Refund Policy

    This is a Cancel-Fee or Deposit Form below!

    This is up to EVENT Planner

    This is up to EVENT Planner

    This is up to EVENT Planner

    author avatar
    hotadmin Owner
    Sean Michaels stage name and expert in the adult entertainment industry with bachelorette parties and bachelor parties.