MANGO'S SEASIDE GRILL

                                            CREDIT CARD HOLD FORM FOR RESERVATIONS OVER 4 PERSONS

                                            CUSTOMER_________________________________________________________

                                            RESERVATION DATE__________________________________________________

                                            RESERVATION TIME__________________________________________________

                                            NUMBER IN PARTY___________________________________________________

                                            CONTACT NUMBER___________________________________________________

                                            STAYING ON ANGUILLA_______________________________________________

OUR CANCELLATION POLICY: NO CHARGE FOR CANCELLING BY 10:00AM THE SAME DAY! ALL CANCELLATIONS MUST BE MADE BY PHONE!  IF THE RESERVATION IS NOT CANCELLED OR IF THE NUMBER OF PERSONS IN THE PARTY CHANGES AFTER THAT TIME THEN A $75 CHARGE PER PERSON WILL BE CHARGED TO THE CREDIT CARD. (Visa/MC/AMX)

NAME ON CREDIT CARD_______________________________________________

CREDIT CARD NUMBER _______________________________________________

EXPIRATION DATE___________________________________________________

SIGNATURE_________________________________________________________

THANK YOU!

DAVID & KIM COBURN (235-6259 OR 235-8028)

MANGO’S SEASIDE GRILL
P.O. BOX 682
ANGUILLA, B.W.I.
264-497-6479
264-497-6492-FAX
MANGOS@ANGUILLANET.COM