Deposit - LA Party Rentals

Credit Card Authorization

Event Title

Pickup Date

Name on Card *

First

Last

Email *

Phone

Credit Card Number

Expiration Date

CCID

Billing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Front of Card Image

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Back of Card Upload

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I agree to use this card for rental and/or deposit

I Agree

Signature

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