Pineapple Village On Line Reservations Form

Guest(s) Name(s)

Address 1    Address 2

City State Zip Country

How can we contact you.

Number of adults Number of children under 12 years of age

Arrival date (Month, Date, Year) Departure date (Month, Date, Year)

Number of nights Total number of rooms

Please enter below the number of rooms required:
Room(s) # Superior Garden Studio
               # Superior Master Garden Bedroom-King/Queen Beds
               # Superior Garden Bedroom-Two Double Beds
               # Entire Villa

*** Only the credit cards listed below are accepted for payment. ***
        *** We also accept payment by check or money orders.***

Method of Payment:

 Please enter YES in the appropriate box above.

**If mailing address is different then billing address, please include that address also below.**

Credit Card Number  

Expires (Month, Date, Year)

Name of cardholder (As it appears on card)

***On Line signature ***  By clicking the SUBMIT button below you authorize us to charge the amount and that you agree to the terms of the rental.

 If you do not hear from us within 24 hours please call us at 1-800-992-9232