New River Whitewater Rafting
West Virginia

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Credit Card Authorization Form
Please authorize Rivermen Whitewater to post the following charge to the credit card specified. This form must be authorized by clicking the appropriate button below. No charges will be processed until your trip and exact pricing is confirmed by phone and/or e-mail.
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Group Information
Reservation Type
 
Payment on Existing Reservation
Group Organizer
 
Conf #
 
Trip
 
Date
 
Billing Information
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Billing Address 1
 
Billing Address 2
 
City/Township
 
State/Zip
 
Phone
 

Email
 
Payment Information
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Credit Card Number
 
Expiration
 
VIN#
 
Total Amt: $
 
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Do you accept the term and conditions of this contract?
 
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Contact The Rivermen at 1-800-545-7238 with any questions. Total invoice amount for reservation implies authorization on all separate charges.

Please be aware that your reservation is not
confirmed until your entire balance is paid in full.