Custom Booking Form

Please complete the form and click the button below. If you have any questions or problems with this form or any questions with regards to the transaction email us at info@urbansurfing.com or call us at (718) 657-1035 for further explanation of the charges.

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Note: All fields are required!
1. Personal Information
First Name:
Last Name:
Email Address:
Address:
City:
State:
Postal Code:
Phone:
I have completed, signed and faxed a
Credit Card Authorization Agreement:

You must follow the instructions below and check this box or your form will not be processed.

Click on one of the following to open the proper Credit Card Authorization Agreement in a new browser window:

DelSol Ticket Auth  [.pdf or .html]
DelSol CC Form  [.pdf or .html]
Delos CC Form  [.pdf or .html]

You must print, complete, sign and fax this agreement to (718) 657-7906. Your reservation will not be completed if we do not receive your signed Authorization Agreement.

 
2. Transaction Information
Charge Amount: $ (Example: 100, 100.50)
Note: All transactions are in US Dollars.
A 3% processing fee applies for credit card transactions.
Description:
Please type a brief description of the product/service you are purchasing (i.e. Airfare to LA, Cruise to Caribbean, etc.)
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